A prospective study was carried out to evaluate the validity of TROPT troponin T rapid assay in early diagnosis of acute myocardial infarction(AMI) in patients with ischemic chest pain, in comparison with conventional diagnostic tools such as serum troponin T(c-TnT) level, creatine Kinase(CK), CK-MB level and initial EKG finding. The study was performed at the emergency department(ED) of Yong Dong Severance hospital from March 1st 1996 to February 28th 1997. One hundred eighty one patients visiting ED with chief complaint of atraumatic chest pain within 24 hours of visit were eligible for the study. Those who lacked enough data collection and those who had chest paint of noncardiac origin and EKG of PSVT were excluded from the study. The overall study population was a total of 131 patients. Initial EKG, TROPT rapid assay, CK, CK-MB and c-TnT level were obtained simultaneously. Diagnosis of AMI was made according to the international diagnostic criteria for AMI. Of the 131 patients 61 patients(46.6%) were diagnosed as AMI. Within 4 hours of their symptom onset, initial EKG showed the highest sensitivity(63.2%) whereas the sensitivities of TROPT rapid assay, c-TnT, CK and CK-MB were poor(0-0.7%). From 4-8 hours, the sensitivities of c-TnT, CK and CK-MB were higher than that of TROPT rapid assay(80% vs. 30%). The sensitivites of TROPT rapid assay, c-TnT, CK and CK-MB rose over time and reached 100% after 8 hours symptom onset. The specificities of the TROPT rapid assay, c-TnT, CK & CK-MB and EKG were all 100% within 8 hours after symptom onset. Discrepancy between TROPT rapid assay and c-TnT was noted in nine patients(6.9%). In this study TROPT rapid assay was valuable in the diagnosis of AMI after 8 hours of symptom onset.
Chest Pain* ; Creatine ; Data Collection ; Diagnosis ; Early Diagnosis ; Electrocardiography ; Emergencies ; Humans ; Paint ; Prospective Studies ; Thorax* ; Troponin ; Troponin T

No abstract available.
Arthritis* ; Immunoblastic Lymphadenopathy*

STUDY DESIGN: Six patients with the lumbar kyphosis who underwent the circumferential fusion by posterior-anterior-posterior method were reviewed retrospectively from January 1998 to June 1999. OBJECTIVES: To determine whether patients with lumbar kyphosis can be successfully treated by circumferential fusion by posterior-anterior-posterior method. SUMMARY OF LITERATURE REVIEW: In the lumbar kyphosis, many procedures have been reported to correct the deformity, including multiple osteotomy, transpedicular vertebral resection, posterior interbody fusion, etc. Circumferential fusion by posterior-anterior-posterior method is suggested in this report as a valuable technique for excellent deformity correction and maintenance. MATERIAL AND METHODS: The surgery consists of posterior structural release with decompression followed by anterior structural release with interbody fusion by use of bone graft and posterior fixation. Clinical and radiologic results of the lumbar lordosis, sacral inclination and C7 plumb-line were assessed. RESULT: The mean segments of anterior and posterior fusion were 2.8 and 3.5 respectively. All clinical symptoms of patients had been improved in more than good. The average angle of lumbar lordosis was corrected from kyphosis 2.8degree preoperatively to lordosis 31.2degree postoperatively. At the last follow-up, the average loss of correction was 2.3degree . The average angle of sacral inclination was corrected from 6.7degree to 50.8degree . The distance from supero-posterior corner of S1 to C7 plumb line was reduced from 11.0 cm to 2.75 cm. CONCLUSION: The circumferential fusion by posterior-anterior-posterior method offer an effective surgical treatment, which produce excellent deformity correction, fusion rate, maintenance of the correction and good clinical outcome.
Animals ; Congenital Abnormalities ; Decompression ; Follow-Up Studies ; Humans ; Kyphosis* ; Lordosis ; Osteotomy ; Retrospective Studies ; Transplants

OBJECTIVE: To identify the factors that could predict the functional outcome in patients with the axonal type of Guillain-Barre syndrome (GBS). METHODS: Two hundred and two GBS patients admitted to our university hospital between 2003 and 2014 were reviewed retrospectively. We defined a good outcome as being "able to walk independently at 1 month after onset" and a poor outcome as being "unable to walk independently at 1 month after onset". We evaluated the factors that differed between the good and poor outcome groups. RESULTS: Twenty-four patients were classified into the acute motor axonal neuropathy type. There was a statistically significant difference between the good and poor outcome groups in terms of the GBS disability score at admission, and GBS disability score and Medical Research Council sum score at 1 month after admission. In an electrophysiologic analysis, the good outcome group showed greater amplitude of median, ulnar, deep peroneal, and posterior tibial nerve compound muscle action potentials (CMAP) and greater amplitude of median, ulnar, and superficial peroneal sensory nerve action potentials (SNAP) than the poor outcome group. CONCLUSION: A lower GBS disability score at admission, high amplitude of median, ulnar, deep peroneal, and posterior tibial CMAPs, and high amplitude of median, ulnar, and superficial peroneal SNAPs were associated with being able to walk at 1 month in patients with axonal GBS.
Action Potentials ; Axons* ; Guillain-Barre Syndrome* ; Humans ; Retrospective Studies ; Tibial Nerve

The other generalized type of epidermolysis bullosa simplex (EBS) is a genetic blistering skin disease, caused by a mutation of the genes encoding keratin 5 and 14. EBS starts at birth and is characterized by generalized blisters following a minor trauma that heals with hyperpigmentation. A 19-year-old man presented with 19-year history of multiple erythematous vesicles in a herpetiform arrangement on the trunk, axilla, and thigh with post-inflammatory hyper-pigmentations. On light and electron microscopy, the biopsy specimen showed intraepidermal blisters that formed within the basal keratinocyte. The serum from a patient with bullous pemphigoid antibody and laminin 5 antibody showed the linear deposition at the floor of the blister on immunofluorescence mapping study. On the basis of our clinical, microscopic, and immunofluorescence findings, we diagnosed the patient as having a generalized type of EBS. Herein, we report on an interesting case of the other generalized type of EBS.
Axilla ; Biopsy ; Blister ; Cell Adhesion Molecules ; Epidermolysis Bullosa ; Epidermolysis Bullosa Simplex ; Floors and Floorcoverings ; Fluorescent Antibody Technique ; Humans ; Hyperpigmentation ; Keratin-5 ; Keratinocytes ; Laminin ; Light ; Methylmethacrylates ; Microscopy, Electron ; Parturition ; Pemphigoid, Bullous ; Polystyrenes ; Skin Diseases ; Thigh

A family with paramyotonia congenita (PC) is presented. At least 10 family members were affected in an autosomal dominant inheritance pattern. The proband had cold-sensitive muscle stiffness, paradoxical myotonia, and intermittent muscle weakness since childhood. The serum level of creatine kinase was mildly elevated and short exercise test with cooling revealed a drastic reduction of compound muscle action potentials with repetitive discharges. Muscle biopsy revealed marked variation in the fiber size and increased internal nuclei. The molecular biological study revealed a common missense mutation (Arg1448Cys) at the voltage-gated sodium channel gene (SCN4A). The repetitive CMAP discharges during short exercise test with cooling observed in the proband has not been reported previously. This observation needs to be confirmed among PC patients with different mutations. This is the first report on a PC family confirmed by the molecular biological technique in Korea.
Adult ; Arginine/*chemistry ; Cell Nucleus/metabolism ; Creatine Kinase/blood ; Cysteine/*chemistry ; DNA Mutational Analysis ; Exercise ; Female ; Humans ; Korea ; Male ; *Mutation, Missense ; Myotonic Disorders/*genetics ; Pedigree ; Phenotype ; Sodium Channels/*genetics/metabolism

PURPOSE: This study was to evaluate temporal changes in the expressions of the phosphorylated extracellular-regulated kinase1/2 (pERK1/2), the phosphorylated MAPK/ERK kinase1/2 (pMEK1/2) and the cFos proteins in the hippocampus of rats following transient global ischemia. METHODS: Transient global ischemia was induced in the forebrains of Sprague-Dawley rats by using a 4-vessel occlusion for 20 min under anesthetic condition. Hematoxyline-eosin staining showed typical microscopic findings that represented neuronal cell death in hippocampal CA1 regions 5 days after transient global ischemia. Four-vessel occlusion-reperfusion produced ischemic injury in major forebrain structures, such as the striatum, the cortex and the hippocampus, in the finding of triphenyltetrazolium chloride (TTC) staining. RESULTS: A high density of pERK1/2 immunoreactivity existed in the pyramidal-cell layers of the CA2-3 regions and in the granular-cell layers of the dentate gyrus 5 min after ischemia. Following ischemia, expression of the pMEK1/2 protein showed temporal changes similar to that of the pERK1/2 protein. A significant expression of the cFos protein was noted in the pyramidal-cell layers of the CA2-3 regions and in the granular-cell layers of the dentate gyrus 2 hours after global ischemia. CONCLUSION: Intracellular signaling cascades of the ERK or the cFos protein take part in early cellular events in the hippocampus of rats in response to ischemic insult.
Animals ; CA1 Region, Hippocampal ; Cell Death ; Dentate Gyrus ; Hippocampus* ; Ischemia ; Neurons ; Prosencephalon ; Rats* ; Rats, Sprague-Dawley ; Reperfusion Injury*

No abstract available.
Nephrotic Syndrome*

PURPOSE: The aim of the present study was to evaluate the effects of low-dose tamsulosin on sexual function in patients with lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia. MATERIALS AND METHODS: A total of 138 male LUTS patients aged more than 50 years with an International Prostate Symptom Score (IPSS) > or =8 were enrolled in this open-label, multicenter, prospective, noncomparative observational study. Clinical assessments included IPSS, quality of life (QoL) index, International Index of Erectile Function (IIEF), Danish Prostate Symptom Score (DAN-PSS), and an early morning erection questionnaire. The data were recorded at baseline and at 1 and 3 months after treatment with tamsulosin 0.2 mg/d. Adverse events were analyzed in all patients. RESULTS: During the study period of 3 months, the IPSS and QoL index significantly improved from baseline by -11.40+/-9.40 and -1.11+/-1.36, respectively (p<0.001). However, there were no clinically relevant changes in total IIEF score (mean difference, 1.63+/-15.50; p=0.406) or the 5 subdomains (p>0.05). Furthermore, DAN-PSS weighted scores (AxB) showed no clinically relevant changes (mean difference on Q1, Q2, and Q3: -0.45+/-2.94, 0.27+/-2.50, and -1.27+/-2.27, p>0.05). In addition, there were no clinically significant changes in responses on the early morning erection questionnaire. CONCLUSIONS: Tamsulosin at the dose of 0.2 mg significantly improved the IPSS and the QoL index compared with baseline. However, tamsulosin did not exhibit any significant impact on sexual function or any negative impact on ejaculatory function.
Aged ; Ejaculation ; Erectile Dysfunction ; Humans ; Lower Urinary Tract Symptoms ; Male ; Prospective Studies ; Prostate ; Prostatic Hyperplasia ; Quality of Life ; Sulfonamides

The giant cell tumor of the salivary gland is very rare, and 20 cases have been reported in the English-language literature. We report an additional case. A 57-year old man had noticed a mass in the right parotid area for several weeks. The diagnosis using aspiration cytology was a giant cell tumor possibly with a carcinomatous component. Superficial parotidectomy was carried out. The resected parotid gland contained a 1.8 cm-sized well-circumscribed brownish tumor. Histologically the tumor consisted of evenly distributed osteoclast-like giant cells, mononuclear cells and two small foci of a carcinomatous component. The osteoclast-like giant cells and mononuclear cells were positive for vimentin and CD68, and the carcinomatous component was positive for cytokeratin and epithelial membrane antigen. There was no metastatic lesion in the cervical lymph nodes. We believe this is the first case in Korea of an osteoclast-like giant cell tumor of the parotid gland.
Male ; Humans ; Neoplasm Metastasis