No abstract available.
Humans

In a jaundiced patient, it is important to ascertain as early as possible whether the bile duct is dilated. Ultrasonography, computed tomography & conventional cholangiography are widely accepted methods of determining the size of the extrahepatic bile ducts. But there is a considerable discrepancy among the size of the bile duct as measured from them. So the author analyzed and compared the respective diameters of the bile ducts in Korean normal adults as measured from cadaver, IV cholangiography, ultrasoud and computed tomography. The materials were 45 cases of cadaver, 38 cases of IV cholangiography, 100 cases of ultrasonography & 55 cases of computed tomography. The results were as follows ; 1. The diameters of the bile ducts were 7.58±2.26mm at CHD & 8.04±2.42mm at CBD from cadaver ; 5.38±1.90mm at CHD & 6.58±2.37mm at CBD from IV cholanglography ; 3.24±1.13mm at CHD & 4.71±1.48mm at CBD from ultrasonography ; and 4.56±1.51mm at CHD & 5.87±1.68mm at CBD from computed tomography. 2. The diameter of the bile duct was greatest in cadaver, and then reduced in IV cholangiography, computed tomography and ultrasonography in this orde.r 3. There were no size discrepancy between the diameter of the common hepatic duct and that of the common bile duct. 4. There were no discrepanry of the diameter of the bile duct by sex.
Adult* ; Bile Ducts* ; Bile Ducts, Extrahepatic ; Bile* ; Cadaver ; Cholangiography ; Common Bile Duct ; Hepatic Duct, Common ; Humans ; Ultrasonography

No abstract available.
Glomerulonephritis, IGA* ; Immunoglobulin A* ; Nephrotic Syndrome*

We reviewed the records of 28 patients who underwent transcranial(20 cases) or transsphenoidal(8 cases) surgery sellar and parasellar tumors. Both pre-and postoperative visual status(visual acuity and field) of each eye were analyzed under the rating system of Cohen, et al. The average duration of follow-up 3 months. The lesions encountered consisted of pituitary adenoma in 14 cases, craniopharyngioma in 5 cases, meningioma in 4 cases, chordoma in 3 cases, a dermoid cyst in 1 case, and an unspecified tumor in another case. All patients had objective signs of visual acuity or field defects preoperatively. Overall postoperative visual acuity and visual fields were normalized or improved in 73% and 71% of the eyes, respectively. The visual outcome of postoperative visual acuity was better in cases of craniopharyngioma(80%) than the other tumors. Visual evoked potentials(VEP) showed all postoperative improvement and was as helpful as visual fields in determining visual status. The visual outcome was better in patients with a shorter duration of symptoms and those with smaller tumors. Patients with lesser compromise of preoperative visual acuity had better outcome of postoperative visual acuity. However, the severity of preoperative visual field defects did not seem to influence postoperative field outcome. There also was no relationship between the presence of endocrine activity of the tumor and visual outcome. Patients who underwent transsphenoidal approach had either better visual acuity or field improvement than patients with transcranial approach.
Chordoma ; Craniopharyngioma ; Dermoid Cyst ; Follow-Up Studies ; Humans ; Meningioma ; Pituitary Neoplasms ; Visual Acuity ; Visual Fields

The mainstay of diagnosing scrub typhus is through serologic testing. However, because of the delay of several days from the onset of the illness to the increase in the antibody titer, diagnosis can be difficult in the early stage of the illness. The aim of this study was to determine the clinical usefulness of adenosine deaminase activity (ADA) in diagnosing scrub typhus. A total of 104 patients were enrolled during the study period. Of these patients, 59 patients were diagnosed with scrub typhus and the mean serum ADA level was 46.7+/-11.6 U/L. High serum ADA levels strongly supported the diagnosis of scrub typhus, especially in patient without eschar. The remaining 44 patients did not have scrub typhus and 95% (42/44) of them had normal serum ADA levels. Therefore, evaluating serum ADA level could help diagnose patients with acute febrile disease such as scrub typhus, especially in its early stage of disease progression.
Adenosine ; Adenosine Deaminase ; Disease Progression ; Humans ; Orientia tsutsugamushi ; Scrub Typhus ; Serologic Tests

The mainstay of diagnosing scrub typhus is through serologic testing. However, because of the delay of several days from the onset of the illness to the increase in the antibody titer, diagnosis can be difficult in the early stage of the illness. The aim of this study was to determine the clinical usefulness of adenosine deaminase activity (ADA) in diagnosing scrub typhus. A total of 104 patients were enrolled during the study period. Of these patients, 59 patients were diagnosed with scrub typhus and the mean serum ADA level was 46.7+/-11.6 U/L. High serum ADA levels strongly supported the diagnosis of scrub typhus, especially in patient without eschar. The remaining 44 patients did not have scrub typhus and 95% (42/44) of them had normal serum ADA levels. Therefore, evaluating serum ADA level could help diagnose patients with acute febrile disease such as scrub typhus, especially in its early stage of disease progression.
Adenosine ; Adenosine Deaminase ; Disease Progression ; Humans ; Orientia tsutsugamushi ; Scrub Typhus ; Serologic Tests

BACKGROUND: Arterial stiffness is a strong indicator of cardiovascular risk. Increased visceral fat confers greater risks of metabolic syndrome and cardiovascular events. The aim of this study was to elucidate the relationships between arterial stiffness and regional distribution of abdominal adiposity (i.e. subcutaneous and visceral adipose tissue). METHODS: Thirty obese participants (M:F=17:13, mean age=53.6+/-12.0 years) underwent anthropometric measurements, laboratory procedures such as serum lipid levels and abdominal computed tomography scan. The aortofemoral pulse wave velocity was measured by foot to foot method using two continuous Doppler waves. RESULTS: Pulse wave velocity was positively associated with age, hip circumference (P<0.01), visceral to subcutaneous abdominal fat ratio and body weight (P<0.05), but independent of the total abdominal, visceral, and subcutanous fat. Although not positively associated, the mean pulse wave velocity tended to be higher in patients with history of hypertension or diabetes. CONCLUSIONS: The site of abdominal fat distribution contribute to the prediction of arterial stiffness and visceral adiposity is associated with increased risk of cardiovascular events.
Abdominal Fat ; Adiposity* ; Body Weight ; Foot ; Hip ; Humans ; Hypertension ; Intra-Abdominal Fat ; Methods ; Pulse Wave Analysis ; Vascular Stiffness*

We report a case of coronary fistula between the left anterior descending and main pulmonary artery complicating acute non-Q wave myocardial infarction. A 27-year-old man visited emergency department because of severe chest pain lasting two hours. The electrocardiogram showed ST segment elevation in precordial leads V3~6. Cardiac enzymes were as follows;CK-MB:36.44 IU/L T-T:0.489 ng/mL, CPK:542 IU/L, and LDH:475 IU/L. The thallium-201 dipyridamole stress perfusion scan showed perfusion defect and reversed redistribution in the anteroseptal wall. The coronary angiogram revealed coronary artery fistula between the proximal left anterior descending artery and main pulmonary artery without significant stenoses of coronary arteries. The result of ergonovine test was negative. After micro-coil embolization to the coronary fistula, symptoms were improved. Follow-up thallium-201 scan showed normalized blood flow in the left anteroseptal wall.
Adult* ; Arteries ; Chest Pain ; Constriction, Pathologic ; Coronary Vessels ; Dipyridamole ; Electrocardiography ; Emergency Service, Hospital ; Ergonovine ; Fistula* ; Follow-Up Studies ; Humans ; Myocardial Infarction* ; Perfusion ; Pulmonary Artery*

OBJECTIVE: The Korean Medication Algorithm for the Treatment of Schizophrenia was developed by the extensive review and questionnaires. To evaluate the impact of a history of antipsychotic treatments on clinical response and algorithm application, using the data derived from the feasibility study of the Medication Algorithm for patients with schizophrenia. METHOD: Outcomes of treatment with the Medication Algorithm for 108 schizophrenics up to 4 months are presented. Measures of changes included clinical symptoms, functioning, and side effects. Comparison was done between patients with and without a history of antipsychotic treatments. RESULTS: 100 individuals (with a history=71 ; without a history=29) were analyzed for the comparison. Most of subjects without a history of antipsychotic treatments were administered on risperidone in the initial treatment. When compared with the subjects with a treatment history, the subjects without a history showed better treatment effects on clinical symptoms at the first evaluation. At 4-month, there were similar effects between the two groups except negative symptoms, in which the group with a history showed significantly more improvement than without a history. There were no significant differences in assessment of subjective opinion and well-being to drugs and quality of life, and objective evaluation of drug side effects. Among the subjects with a history, the ones starting with stage 1 showed higher positive symptoms, anxiety scores, and briefer duration of antipsychotic exposure than the ones starting with stage 2 or more advanced. CONCLUSION: This study suggests that despite some limitation, an antipsychotic treatment history may have an impact on application of medication algorithm and these data will be helpful for revision of the Medication Algorithm for the Treatment of Schizophrenia.
Anxiety ; Feasibility Studies ; Humans ; Quality of Life ; Surveys and Questionnaires ; Risperidone ; Schizophrenia

PURPOSE: Previously, Epstein-Barr virus (EBV) infection was diagnosed by serological examination; currently, many EBV antigen detection methods have been developed and applied clinically for diagnosing EBV infection. To delineate the clinical characteristics of EBV infection, clinical and laboratory findings were evaluated for patients who tested positive in EBV polymerase chain reaction (PCR). METHODS: EBV PCR was conducted in 352 patients admitted to the pediatric ward from January 2004 to December 2006, with more than 2 clinical signs such as fever (> or =37.5degrees C), exudative throat infection, lymphadenopathy, hepatitis of unknown etiology, and splenomegaly. The EBV viral gene was detected by PCR in 115 patients (32%), and the clinical characteristics of these patients were evaluated. Laboratory findings such as leukocytosis, thrombocytopenia, atypical lymphocyte, and alteration in aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels in peripheral blood were examined. The EBV-specific immunoglobulin M antibody (EBV-IgM Ab) was also tested. RESULTS: Most of the children were younger than 8 years (89%), and the male to female ratio was 1.3:1. Exudative throat infection and fever (> or =37.5degrees C) were observed in all patients. Cervical lymph node enlargement was seen in 36 patients (31%); leukocytosis (WBC> or =10,000/mm3), in 54 patients (47%); and atypical lymphocyte (> or =20%), in 28 patients (24%). EBV-IgM Ab was positive in 33 patients (29%). The younger patients had higher ALT levels and higher incidence of positive EBV-IgM Ab than the older patients. CONCLUSION: The cumulative number of patients diagnosed to have EBV infection by PCR increased markedly for those under 8 years. ALT was higher and EBV-IgM Ab was detected more in younger patients with EBV infection.
Alanine Transaminase ; Aspartate Aminotransferases ; Child ; Epstein-Barr Virus Infections ; Female ; Fever ; Genes, Viral ; Hepatitis ; Herpesvirus 4, Human ; Humans ; Immunoglobulin M ; Incidence ; Leukocytosis ; Lymph Nodes ; Lymphatic Diseases ; Lymphocytes ; Male ; Pharynx ; Polymerase Chain Reaction ; Splenomegaly ; Thrombocytopenia