BACKGROUND: Carcinoembryonic antigen (CEA) is a glycoprotein on cellular surface, which is highly condensed in embryonic tissue and tumor of various kinds. Previous study found out that CEA may grow with various cancer or other diseases other than cancer as well. Besides, it is widely known that smoking also influences the rise in CEA. Among the same smokers, some of them show high CEA figures in serum when others remain in normal range. There are those whose pulmonary function is not influenced by smoking when that of others are susceptible to it. Therefore, this study was undertaken with an aim to study the relationship between serum CEA and pulmonary function by investigating how the change in pulmonary function caused by smoking influences serum CEA. METHODS: From Nov, 1997 to Feb, 2001, this study carried out tests on adult male smokers ages 35 to 64 who visited a hospital located in Kang Nung city. The subjects were divided into two groups: one group of 29 subjects with high CEA with over 6.0 ng/ml with normal colon study; the other group, which is the CEA normal group, consisted of 58 subjects selected through age adjusted random sampling. Data on personal information, smoking and clinical history was collected from a questionnaire. CEA was tested using radioimmunoassay of Abott. Pulmonary function was examined using Analyzer assembly Vmax 20C from Sensormedics Company. These examinations was limited to those who have been screened not to have cancer by chest X-ray, abdominal ultrasonography, and duodenofibroscopy. RESULTS: Smoking per day for the group with high serum CEA was 1.3 pack ( 0.4 pack), which was found to be significantly higher compared to that of normal group (P<0.01). Pack-years with high serum CEA group was 32.6 13.5 which was also comparatively higher than that of the normal group with 22.4 10.9 (P<0.01). Pulmonary function test indicated that FEV1 for the group with high serum CEA was 3.0 0.5 L, which marked lower than that of the normal group with 3.4 0.5 L (P<0.05). After compensating for age and pack years, FEV1 decreased in proportion to the rise in CEA. CONCLUSION: This study has established a link between serum CEA and daily smoking, pack years, and pulmonary function and found that FEV1 was inversely proportionate to the rise in CEA regardless of corrected pack years and daily smoking. Consequently, serum CEA alone is thought to be related to the pulmonary function. Therefore, it is advised that smokers with high serum CEA need to take heed of the influence on pulmonary function.
Adult ; Carcinoembryonic Antigen* ; Colon ; Glycoproteins ; Humans ; Male* ; Radioimmunoassay ; Reference Values ; Respiratory Function Tests ; Smoke ; Smoking ; Thorax ; Ultrasonography ; Surveys and Questionnaires

BACKGROUND: Recently, Doppler echocardiography has been widely used to evaluate left ventricular(LV) diastolic filling. However, There are only limited date about the influence of LV systolic function on the pattern of left ventricular diastolic filling. METHODS: To evaluate the changes of Doppler echocardiographic parameters of left ventricular filling induced by variations in left ventricular systolic function in dilated cardiomyopathy(DC) with heart failure(HF), 25 patients(M : F=14 : 11) with DC and HF, and 21 age-matched normal subjects(M : F=13 : 8) were examined by ECG, phonocardiography and echocardiography. From the Doppler recording, A2D(time from second heart sound to the onset of early diastolic mitral flow), peak velocity at early diastole(E) and late diastole(A), ratio of E to A velocity(E/A) and flow velocity integral(FVI) were measured. RESULTS: In 22 patients with DC and HF without mitral regurgitation(MR), A2D was significantly prolonged(119.5+/-12.7 vs 92.4+/-14.1msec, p<0.01), and early diastolic peak velocity and E/A velocity ratio were decreased as compared with the normal subjects(E=0.39+/-0.08 vs 0.57+/-0.12m/sec, p<0.01, E/A : 0.87+/-0.19 vs 1.33+/-0.19 vs 1.33+/-0.18, p<0.05). There were significant correlations between A2D and FVI(r=+0.73, p<0.01), and between E/A velocity ratio and FVI(r=-0.78, p<0.01). However, in 3 patients with MR, A2D(88.7+/-12.1msec), E(0.56+/-0.05m/sec), and E/A(1.32+/-0.12) were similar to those in normal subjects, despite of decreased FVI(12.0+/-0.9cm). CONCLUSIONS: These data show that a change of left ventricular systolic function in patients without MR may influence a diastolic filling pattern of left ventricle but not in patient with MR, and suggest that MR masks left ventricular distolic filling abnormalities.
Cardiomyopathy, Dilated* ; Echocardiography ; Echocardiography, Doppler* ; Electrocardiography ; Heart ; Heart Sounds ; Heart Ventricles ; Humans ; Masks ; Phonocardiography ; Ventricular Function, Left*

OBJECTIVE: To compare ultrasonography guided versus blind approach in a randomized trial examining the efficacy of suprascapular nerve block in patients with non-specific shoulder pain. METHOD: A total of 20 patients with shoulder pain lasting for more than 1 month were included in this study. After 1:1 randomization, patients were included either in the blind group (n=10) or in the ultrasonography guided group (n=10) of suprascapular nerve block. All patients were evaluated before and after treatment, in terms of shoulder pain and disability index (SPADI) and nerve conduction study. RESULTS: Significant improvements were seen in all pain scores and disability after both types of nerve block, with no significant difference in the improvement of pain and disability between the two approaches. However, amplitude changes of nerve conduction study were larger in ultrasonography guided approach than blind approach. CONCLUSION: This study suggests ultrasonography guided approach of suprascapular nerve block could place the needle closer to the nerve compared to blind approach.
Humans ; Hypogonadism ; Mitochondrial Diseases ; Needles ; Nerve Block ; Neural Conduction ; Ophthalmoplegia ; Random Allocation ; Shoulder Pain

OBJECTIVE: To evaluate the effect of extracorporeal shock wave therapy (ESWT) in plantar fasciitis with visual analog scale score and thickness of fascia by ultrasonography. METHOD: The subjects consisted of 32 feet (24 patients) with established diagnosis of chronic plantar fasciitis, including 17 feet in the ESWT group and 15 feet in the control group. In the ESWT group, three session of ESWT (0.24 mJ/mm2 FED, 1,200 impulse, weekly) were performed. The visual analog scale (VAS) score and thickness of the plantar fascia were measured by ultrasound before therapy and at the 6-week and 6-month follow-up. Patients in the control group were treated with medication, orthotics, physical therapy and exercise program. VAS and thickness of plantar fascia was evaluated at the same time as ESWT group. RESULTS: In the ESWT group, thickness of plantar fascia decreased significantly at 6-week follow-up (p <0.05) and 6-month follow-up (p <0.05). Control group showed no significant difference at follow-up (>0.05). Visual analog scale score showed no significantly difference at 6-week follow-up (>0.05), but decreased at 6-month follow-up. On the other hand, in the control group, thickness of plantar fascia did not change significantly at 6-week follow-up (>0.05) and 6-month follow-up (>0.05). VAS score was not significant different at the 6-week follow-up (>0.05), but decreased at the 6-month follow-up (p <0.05). CONCLUSION: ESWT in plantar fasciitis is effective in relieving subjective pain and reducing thickness of plantar fascia at 6-month follow-up.
Fascia ; Fasciitis, Plantar ; Follow-Up Studies ; Foot ; Hand ; Humans ; Shock

We experienced a rare clinical manifestation of a digoxin induced catatonic stupor without other features of digoxin toxicity. This case suggests that the neurological manifestation of digoxin toxicity can occur without the usual side effects. Also, a serum digoxin level should be checked in any elderly patient presenting with abnormal cerebral func-tions, irrespective of whether or not the dose of digoxin has been changed. (J Korean Neurol Assoc 19(4):438~439, 2001)
Aged ; Digoxin ; Humans ; Neurologic Manifestations ; Stupor*

A 38-year-old woman, affected by chronic myeloid leukemia, received a BMT from his HLA identical brother. A mild acute graft-versus-host disease (GVHD) developed during the first month after the BMT. A typical clinical and electrophysiological feature of myasthenia gravis (MG) developed 3 months after the BMT requiring medication with pyridostigmine and steroids. Laboratory findings including acetylcholine receptor antibody and other autoantibodies were negative. MG is a well-characterized autoimmune disease which, on rare occasions, is also diagnosed as chronic GVHD after BMT. We report a first case of MG during an acute GVHD period. Since the patient had a myasthenic symptom during an acute GVHD period and no evidence of antibody mediated autoimmunity, this is likely to be an immune complication of acute GVHD. (J Korean Neurol Assoc 19(1):60~61, 2001
Acetylcholine ; Adult ; Autoantibodies ; Autoimmune Diseases ; Autoimmunity ; Bone Marrow Transplantation* ; Bone Marrow* ; Female ; Graft vs Host Disease ; Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Myasthenia Gravis* ; Pyridostigmine Bromide ; Siblings ; Steroids

PURPOSE: The purpose of this study was to construct a fetal animal model of congenital diaphragmatic hernia in a lamb under domestic environments. METHODS: Left-sided diaphragmatic hernias were created in seven fetal lambs at about 85 days' gestation (experimental group). Three other fetal lambs did not receive any surgical procedure and served as control group. Four of these lambs (3 in the experimental group and 1 in the control group) were delivered after a sufficient intrauterine period. The morphological changes of lung development were compared between the two groups. RESULTS: Creation of diaphragmatic hernia resulted in marked hypoplasia in fetal lung development. In this experiment, the maternal mortality was 33.3%, and the fetal mortality was 60% which are relatively high as compared with previous reports. CONCLUSION: From this data, the authors concluded that experimental fetal diaphragmatic hernia can be established although the technique for the measurement of gestational age, anesthesia and postoperative care should be improved to overcome domestic inexperience in using the lamb as an experimental animal.
Anesthesia ; Animals ; Fetal Mortality ; Gestational Age ; Hernia, Diaphragmatic* ; Lung ; Maternal Mortality ; Models, Animal ; Postoperative Care ; Pregnancy

OBJECTIVES: Deep brain stimulation (DBS) of subthalamic nuclei (STN) is one of the current modalities of refractory epilepsy, but its exact mechanism and route of action have not been elucidated yet. We investigated the effect of STN stimulation on the development and propagation of seizures in the rats with lithium-pilocarpine induced status epilepticus in its functional anatomy. METHODS: Both pilocarpine injection and high frequency stimulation on STN (HFSSTN) were provided to rats (STN group, n=12), but pilocarpine injection with no stimulation was done on the sham group (n=8). The latency to first discrete ictal discharges and the latency to status epilepticus (SE) were analyzed and the electrical stimulation lasted for 30, 60, 90, 120 minutes after its first discrete spikes. After stimulation, the rats were immediately decapitated for immunohistochemistry and histologic examination. RESULTS: Both the latency to first discrete ictal discharges and the latency to the onset of SE were delayed in the STN group than in the sham group. The latency to the first SE was also more delayed in the STN group (42.7+/-7.9 min) than in the sham group (p<0.05). Remarkably, there was marked Fos immunoreactivity (FIR) on the reticular thalamic nuclei in the STN group, but not in the sham group. CONCLUSIONS: Increased FIR in the reticular thalamic nuclei during HFSSTN suggested that the facilitation of the inhibitory thalamic output prevented generalized motor seizure behavior. We assume that HFSSTN has a pivotal role in the suppression or progression to SE, but cannot prevent seizure onset.
Animals ; Deep Brain Stimulation ; Electric Stimulation* ; Epilepsy ; Immunohistochemistry ; Pilocarpine ; Rats* ; Seizures ; Status Epilepticus* ; Subthalamic Nucleus* ; Thalamic Nuclei

The authors present a case of germinoma in corpus callosum extending to the both frontal lobes with cystic change, in a 27-year-old male. Bilaterallity and cystic change simulated a cystic astrocytoma or a butterfly glioblastoma. The interest in this case is due to the unusual location and the nature of the tumor.
Adult ; Astrocytoma ; Butterflies ; Corpus Callosum ; Frontal Lobe ; Germinoma* ; Glioblastoma ; Humans ; Male

BACKGROUND: The recurrent temporal lobe epilepsy induces contralateral cell damage and secondary epileptogenesis in the contralateral hippocampus of rats. This phenomenon is fairly constant and has been used as a model of human temporal lobe epilepsy. It is necessary to understand this patho-mechanism in order to prevent this cell damage. METHODS: We have investigated the patho-mechanism of secondary epileptogenesis by using the rat model injected with kainic acid (KA) into the unilateral hippocampus. KA model shows initial complex partial seizures originating from the limbic structures and following convulsive status epilepticus. Immunohistochemical staining for c-fos expression, TUNEL stain for apoptosis, and hematoxylin-eosin (H-E) stain for morphologic changes were used. RESULTS: In the injected hippocampus, transient activation of c-fos was expressed in the dentate gyrus and CA3 hippocampal area, which were shaded out within 24 hours after the onset of limbic seizure. The stained cell with normal appearance was not observed in the H-E stain after 72 hours due to diffuse cell death. In the contralateral hippocampus, transient expression of c-fos was observed in the dentate gyrus, hilus, CA3, and CA1 area. But the expression of c-fos in the CA3 and CA1 area was sustained to 24 hours. Cell loss was mild in the CA3 and hilus, and mild cell degeneration and shrinkage were observed in the CA1 area. Apoptotic body was expressed in the CA1 area at 72 hours after the onset of seizure. CONCLUSION: These results mean that the area of prolonged expression of c-fos is vulnerable to apoptosis. Also it suggests that the patho-mechanism of ipsilateral hippocampus is an acute cytotoxic edema, whereas the contralateral damage is an apoptosis.
Animals ; Apoptosis ; Cell Death* ; Dentate Gyrus ; Edema ; Epilepsy, Temporal Lobe ; Hippocampus* ; Humans ; In Situ Nick-End Labeling ; Kainic Acid ; Models, Animal ; Neurons* ; Rats* ; Seizures* ; Status Epilepticus