BACKGROUND: It has been well known that absolute and interpeak latencies of brainstem auditory evoked potentials (BAEP) are usually prolonged in diabetics. However, Its etiology is still controversial. We tried to identify whether the cause is structural or metabolic in origin by performing BAEP and brain MRI in the diabetic patients. METHODS: BAEP were performed in both the diabetic patients (DM) group (16 males and 15 females) and the normal control group (25 males and 33 female). A brain MRI was performed in the DM group on those who showed abnormal BAEP and com-pared the results of BAEP of the DM group with those of the control group. RESULTS: 7 patients (22.6%) showed abnor-mal BAEP (male; 6, female; 1, unilateral; 4, bilateral; 3) when abnormal BAEP was defined as being larger than two and a half standard deviations of the control group BAEP results. Two males of the DM group who showed abnormal structural lesions of the pons in their brain MRI were not included in the statistical analysis. The remaining 14 diabetic male patients (mean age: 58.7 +/-9.1 years, mean disease duration: 6.1 +/-4.7 years, mean hemoglobin (Hb) A1C: 7.7 +/- 2.0%) and 15 diabetic female patients (mean age: 60.6 +/-10.8 years, mean disease duration: 5.4 +/-5.1 years, mean HgA1C: 7.8 +/-2.1%) were stastistically analyzed. Interpeak latencies of I-III, III-V, and I-V were found to be signifi-cantly prolonged in the DM group. The prolongation of interpeak latencies of I-III and I-V were found to be signifi-cantly correlated with the disease duration only in the diabetic female patients, but not with age and HbA1c. CONCLUSIONS: These findings suggest that both metabolic derangement and structural lesion contribute to prolonging the central conduction time on BAEP pathway in diabetics.
Brain ; Brain Stem* ; Diabetes Mellitus ; Evoked Potentials, Auditory, Brain Stem* ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Pons

Oral cholecystogaraphy after ingestaion of the 3.0 gr. Sodium tyropanoate (Bilopaque) was done in 504 patiens from Jan. 1983 to Aug. 1983. Simple supine views of the abdomen of 37 patient, in whom the gall bladder was eithrer nonvisualized or faintly visualized upto 17 houurs after Bilopaque administration, were reviewed in search of the presence of conjugatd material in the bowel. The results were as follows; 1. The ratio of male to female was nearly 2:3, and age distribution was even from 20 years to 79 years. 2. Among 26 cases which showed conjugated Bilopaque in the bowel, cholecystitis with stoens was 20 cases(77% and acalculus cholecystitis was 6 cases(23%).3. Among 11 cases which showed no conjugated Bilopaque in the bowel hepatitis was 3 cases (28%) and clonorchis sinensis, salmonellosis, pancreatitis, acute gastrities was 2 cases (13%) respectively. 4. All of the 20 cases of cholecystitis with stone showed conjugated Bilopaque in the bowel. 5. Among 6 cases of which conjugated Bilopaquein the bowel, salmonellosis was 1 case(17%) and remaining 5 cases (83%) were acalculus cholelcystitis. 6. The results of our study show that the presence of conjugated Bilopaque in the bowel in nonvisualized or faintly visualized gall bladder after oral cholecystography is of definite indicative of cholecystitis. 7. Surgical intervention or ultrasonographic examination of the gall bladder without double dose or second dose oral cholecystography on such cases is recommended.
Abdomen ; Age Distribution ; Cholecystitis ; Cholecystography ; Clonorchis sinensis ; Female ; Hepatitis ; Humans ; Male ; Pancreatitis ; Salmonella Infections ; Tyropanoate ; Urinary Bladder

Actinomycosis is a chronic, granulomatous suppurative disease caused by Actinomyces species. Actinomyces is an anaerobic, gram positive organism that requires special techniques for culture and isolation. Actinomycosis is characterized by formation of multiple abscesses, draining sinuses, abundant granulations (sulfur granule) and dense fibrous tissue. The three major clinical presentations include the cervicofacial, thoracic, and abdominal regions. Since A. israelii is a normal inhabitant of the oral cavity, to make a definitive diagnosis it must be recovered from closed tissue spaces, draining sinuses, or abscesses, or it must be shown to be invasive in histopathologic sections. The drug of choice is penicillin. Because of the dense fibrous tissue surrounding the colonies of organisms and the concentration of organisms in clusters, high doses of pharmacologic agents must be used for long periods, and radical surgical excision should accompany antibiotic therapy if possible. We report three cases of abdominal actinomycosis, preoperatively impressed as appendicitis and pelvic abscess, which was diagnosed by a histological study of operative specimens. The possible pathogenic mechanisms causing clinical symptoms are discussed.
Abscess ; Actinomyces ; Actinomycosis* ; Appendicitis ; Diagnosis ; Mouth ; Penicillins

BACKGROUND AND OBJECTIVES: The purpose of this study was to investigate the relationship between chronic atrial fibrillation (AF) and reduced pulmonary function. SUBJECTS AND METHODS: Eighty-six chronic AF patients who were enrolled from annual health examination programs were studied using echocardiography and pulmonary function tests (PFT). Echocardiography and PFT matched for age, gender, and year performed were selected by the control group who had normal sinus rhythms. Patients with ejection fractions <50%, valvular heart disease, or ischemic heart disease were excluded. RESULTS: In the chronic AF patients, the forced expiratory volume at one second (FEV1), FEV1%, and FEV1/forced vital capacity (FVC) were significantly reduced, and the right ventricular systolic pressure was significantly increased. Episodes of heart failure were more frequently associated with the chronic AF patients than the controls. In particular, the FEV1% had the most meaningful relationship to chronic AF after an adjustment for cardiovascular risk factors {p=0.003, Exp (B)=0.978, 95% confidence interval (CI):0.963-0.993}. CONCLUSION: Reduced FEV1%, which represents the severity of airway obstruction, was associated with chronic AF, and the greater the pulmonary function impairment, the greater the co-existence with AF and congestive heart failure in those with preserved left ventricular systolic function.
Airway Obstruction ; Atrial Fibrillation ; Blood Pressure ; Echocardiography ; Forced Expiratory Volume ; Heart Failure ; Heart Valve Diseases ; Humans ; Myocardial Ischemia ; Pulmonary Disease, Chronic Obstructive ; Respiratory Function Tests ; Risk Factors ; Vital Capacity

PURPOSE: It has been reported that varicocele is found less frequently in obese men. Accordingly, we evaluated varicocele patients and statistically analyzed the correlation between varicocele and somatometric parameters. MATERIALS AND METHODS: A total of 211 patients underwent surgery for varicoceles. All patients underwent history taking, physical examination, and scrotal ultrasound to determine the presence and severity of varicocele. An age-matched control group consisted of 102 patients who were found not to have varicocele according to physical examinations and scrotal ultrasound. The age, weight, height, and body mass index (BMI) of the two groups were compared. The statistical analyses were performed by use of PASW Statistics ver. 18.0. A p-value of less than 0.05 was used for statistical significance. RESULTS: In the varicocele group, the mean age, height, weight, and BMI were 29.42+/-14.01 years, 168.53+/-9.97 cm, 62.14+/-13.17 kg, and 21.66+/-3.21 kg/m2, respectively. The distribution of varicocele grade was as follows: 103 (48.8%) grade III, 72 (34.1%) grade II, and 36 (17.1%) grade I. In the control group, the mean age, height, weight, and BMI were 30.83+/-17.31 years, 161.93+/-19.83 cm, 64.69+/-17.86 kg, and 24.04+/-3.64 kg/m2, respectively. Analyzing these data specifically in adolescents, they showed significant differences in age, height, and BMI (p=0.000, p=0.000, and p=0.004, respectively) between two groups. There were no significant differences in somatometric parameters between patients with different grades of varicocele. CONCLUSIONS: Our results showed that patients with varicoceles were significantly taller and had a lower BMI than did patients without varicoceles, especially among adolescents. Carefully designed future studies may be needed.
Adolescent ; Adult ; Anthropometry/methods ; Body Height/physiology ; Body Mass Index ; Body Weight/physiology ; Case-Control Studies ; Humans ; Male ; Scrotum/ultrasonography ; Varicocele/*etiology/physiopathology/ultrasonography ; Young Adult

BACKGROUND AND PURPOSE: Recently published, evidence-based guidelines should alter the management of amyotrophic lateral sclerosis (ALS)/motor neuron disease (MND). However, the newest recommendations for ALS/MND therapy are not reflected in actual clinical practice. We sought to evaluate the current status of the diagnosis and management of ALS in Korea. METHODS: The Korean ALS/MND research group was organized in 2010, involving more than 50 neurologists from neuromuscular centers in Korea. Participating centers collected data from April to September 2010 on the diagnosis and management of patients with ALS. Data forms from the ALS patient care database, which is a component of the ALS clinical assessment, research, and education program (http://www.outcomes-umassmed.org/ALS/), were modified and used for data collection. RESULTS: In total, 373 sporadic ALS cases from 35 centers were enrolled. The demographic features and clinical findings were similar to those in previous reports from other countries. The mean age at onset was 50-60 years, and a slight male predominance was observed. The enrolled patients predominantly showed focal onset of cervical or lumbosacral symptoms. Only about one-half of the indicated patients (31.4%) received a physician's recommendation for a parenteral gastrostomy, and 18.1% underwent the procedure. Noninvasive ventilation was recommended in 23% of patients, but applied in only 9.5% of them. Tracheostomy was performed in 12.7% of patients. CONCLUSIONS: The demographic and clinical features of the diagnosis and management of ALS in Korea are similar to those reported in other countries; however, supportive management, as recommended in evidence-based guidelines, are not yet widely recommended or performed for patients with ALS in Korea.
Amyotrophic Lateral Sclerosis ; Cross-Sectional Studies ; Gastrostomy ; Humans ; Korea ; Male ; Neurons ; Noninvasive Ventilation ; Palliative Care ; Patient Care ; Tracheostomy

PURPOSE: Postoperative hypocalcemia is a common complication compared with the other complications following total thyroidectomy due to thyroid carcinoma. We evaluated the incidence of transient and permanent hypocalcemia and the preservation status of the parathyroid glands following total thyroidectomy due to thyroid carcinoma. METHODS: We analyzed a total of 145 cases of total thyroidectomy due to thyroid carcinoma. The preservation status of the prarathyroid glands after total thyroidectomy was classified as intact preservation or ischemic change, according to the number of intact preserved parathyroid glands in group 1 (more than 2), group 2 (1) or group 3 (0). RESULTS: Permanent hypocalcemia was not found in group 1. The rate of transient or permanent hypocalcemia was significantly lower in group 2 than that in group 3 (P< 0.05). CONCLUSION: The parathyroid glands should be preserved to minimize the occurrence of hypocalemia after performing total thyroidectomy. The number of intact preserved parathyroid glands can be a good indicator for predicting the occurrence of post-total thyroidectomy hypocalcemia.
Humans ; Hypocalcemia* ; Incidence ; Parathyroid Glands ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy*

Left ventricular(LV) diastolic filling is abnormal at rest in many patients with coronary arery disease, even in the presence of normal resting LV systolic function. To determine the effects of improved myocardial perfusion on impaired LV diastolic filling and to detect the most sensitive parameter to assess LV diastolic function, gated radionuclide ventriculography were performed in 14 patients with coronary artery disease before and after successful percutaneous transluminal coronary angioplasty(PTCA). All patients had no previous myocardial infarction and no abnormal wall motion in gated radionuclide and contrast ventriculography. The following results were obtained; 1) There were no significant differences in the parameters of LV systolic function, such as peak ejection rate(PER, time to peak ejection rate(TPER), ejection fraction(EF) after successful PTCA. 2) Peak filling rate(PFR) and time to peak filling rate(TPFR), indexes of LV diastolic function, had no significant changes after successful PTCA. 3) The percent contribution of late diastolic filling to stroke volume(%LDF/SV) decreased from 26.5+/-6.8% to 19.1+/-6.6%(p<0.005 by paired t-test). These data suggest that in many patients with angina and normal LV systolic function, impaired global diastolic filling is a reversible manifestation of impaired coronary flow, and percent contribution of late diastolic filling to stroke volume(%LDF/SV) can be a sensitive parameter to evaluate impaired LV diastolic filling in coronary artery disease.
Angina Pectoris* ; Angioplasty, Balloon, Coronary* ; Coronary Artery Disease ; Gated Blood-Pool Imaging ; Humans ; Myocardial Infarction ; Perfusion ; Radionuclide Ventriculography ; Stroke

BACKGROUND: C-type natriuretic peptide (CNP), secreted from endothelial cells, dilates the vessel and increases the renal excretion of sodium and water. Plasma CNP level is not elevated in patients with congestive heart failure (CHF), but the myocardial content of CNP is increased, suggesting paracrine or autocrine role of CNP. We studied to compare the effect of ANP and CNP on vasorelaxation in CHF rat model. METHODS: Coronary artery ligation was performed in Sprague Dawley rats, resulting in CHF (n=5) and they were fed with ordinary chow for 10 weeks. After measuring hemodynamics, aorta and pulmonary artery were incised and studied in organ chamber to measure the isotonic force to KCl and to observe the relaxation response to atrial natriuretic peptide (ANP), and CNP in vessels precontracted with phenylephrine. Normal Sprague Dawley rats (n=5) were used as control. RESULTS: There were no difference in vasorelaxation responses to ANP between control and CHF rats. The response to CNP was significantly impaired in both aorta and pulmonary artery of CHF rats compared to control rats.
Animals ; Aorta* ; Atrial Natriuretic Factor ; Coronary Vessels ; Endothelial Cells ; Estrogens, Conjugated (USP)* ; Heart Failure* ; Hemodynamics ; Humans ; Ligation ; Models, Animal ; Myocardial Infarction ; Natriuretic Peptide, C-Type* ; Natriuretic Peptides ; Phenylephrine ; Plasma ; Pulmonary Artery* ; Rats* ; Rats, Sprague-Dawley ; Relaxation* ; Sodium ; Vasodilation

Interleukin-1beta(IL-1beta), which is released into the peritoneal cavity during peritonitis in continuous ambulatory peritoneal dialysis(CAPD) patients, stimulates the production of extracellular matrix proteins, including fibronectin and type, I collagen, in the cultured peritoneal mesothelial cells(HPMCs). This may participate in the development of peritoneal fibrosis developing after episodes of peritonitis. Heparin stimulates the fibrinolysis and it is a routine practice to put 0.5-1U/mL of heparin into the dialysis fluid to prevent the formation of fibrin clot. Besides the anticoagulant acivity, heparin has diverse biologic effects on the cells. In this study, we investigated the effect of heparin on the production of fibronectin, one of the extracellular matrix proteins, in the cultured human peritoneal mesothelial cells. Incubation of the cultured HPMCs with IL-1beta(1 ng/mL) caused an increased expression of fibronectin mRNA by the cells. This stimulatory effect of IL-18 on the expression of fibronectin mRNA was inhibited by heparin, dose-dependently as well as time-dependently. The expression of fibronectin mRNA in the unstimulated cells was also inhibited by heparin. The amount of secreted fibronectin in the culture supernatant was decreased by heparin(1U/mL). This inhibitory effect was present regardless of the addition of IL-lbeta. However, IL-lbeta-induced increase in the expression of TGF bata1 mRNA in the cultured HPMCs was not inhibited by heparin. In conclusion, heparin inhibited the production of fibronectin by the cultured HPMCs at the concentration used clinically during peritonitis in CAPD patients. This suggests that heparin may have a preventive effect on the development of peritonitis associated peritoneal fibrosis as well as decrease the formation of fibrin clot.
Collagen ; Dialysis ; Extracellular Matrix Proteins ; Fibrin ; Fibrinolysis ; Fibronectins ; Heparin* ; Humans* ; Interleukin-18 ; Interleukin-1beta ; Peritoneal Cavity ; Peritoneal Dialysis, Continuous Ambulatory ; Peritoneal Fibrosis ; Peritonitis ; RNA, Messenger