Exercise testing with Thallium imaging is widely used for the noninvasive evaluation of patients suspected of having coronary artery disease. However, many patients referred for stress testing connot exercise adequately for either physical or psychological reasons, and as a result may have nondiagnostic or suboptimal test results. Intravenous dipyridamole in conjunction with Thallium imaging is as effective alternative method without exercise. But, myocardial imaging using the standard scintillation camera technique(planner view) is hampered by superposition of proximal & distal cardial walls and by the segmental nature of myocardial ischemia. For this reason, Single Photon Emission Computed Tomography(SPECT) reslut in high specificity & sensitivity rates for the detection of coronar artery disease compared with conventional technique. So we performed dipyridamole Th-201 myocardial scintigraphy on 25 subjects who have suspicious angina or myocardial infarction instead of exercise Th-201 myocardial scintigraphy, and compared SPECT view with conventional plannar view. The results obtained are as follows : 1) T1-201 scintigraphic findings in 17 patients with suspicious angina were as follows ; redistribution defect was seen in 4 cases in plannar view and 13 cases in SPECT view. 2) T1-201 scintigraphic findings in 8 patients with myocardial infarction were as follows ; in planner view, perfusion defect was seen in all cases and 1 cases of them, redistribution defect was accompained, and in SPECT view, perfusion defect was seen in all cases and 6 cases of them, redistribution defect was accompained. 3) During dipyridamole infusion, the mean systolic & diatolic pressure decreased from 133+/-22.7/86+/-13.5 to 121+/-23.9/78+/-13.1mmHg and the heart rate increased from 68+/-12.4 to 84+/-12.4beats/min. 4) Adverse effects of dipyridamole were noted in 14(56%) of the subjects, but in 12 of these, the symptoms were mild in severity and subsided spontanously. To summarize, Dipyridamole-201 myocardial imaging is a useful and test for coronary artery disease, and the new tomographic technique, SPECT view, is more useful than the conventional plannar view.
Arteries ; Coronary Artery Disease ; Dipyridamole* ; Exercise Test ; Gamma Cameras ; Heart Rate ; Humans ; Myocardial Infarction ; Myocardial Ischemia ; Myocardial Perfusion Imaging ; Perfusion Imaging* ; Perfusion* ; Sensitivity and Specificity ; Thallium* ; Tomography, Emission-Computed, Single-Photon*

OBJECTIVE: The purpose of this study is to identify risk factors related to the fusion failure after halo-vest immobilization of odontoid fracture type III. METHODS: We retrospectively analyzed ten patients who underwent halo-vest immobilization for acute traumatic odontoid fracture between October 2002 and December 2011. All patients had type III odontoid fracture using the Anderson and D'Alonzo classification. We reviewed digital radiographs and analyzed the images during conservative treatment with halo-vest immobilization. RESULTS: The patients consisted of nine men and one woman, with mean age of 40.2 years (range: 25-56), who had no history of medical comorbidity and significant neurologic deficit. The mean follow-up period was 6 months (range: 4-11). All patients were initially treated by halo-vest immobilization. Seven patients showed union of fractured site on radiologic findings after halo-vest immobilization only. However, other 3 patients underwent surgery for fixation due to fusion failure. Among the factors we analyzed such as, radiographic characteristics and clinical feature, presence of comminuted fracture, instability of fractured fragment and failed reduction of misalignment were the factors related to fusion failure. CONCLUSION: The fusion rate of halo-vest immobilization of odontoid fracture type III seem to be incomplete, but clinical decision using the risk factors such as comminution, instability of fractured fragment and failed reduction of misalignment improves the outcome with conservative management.
Comorbidity ; External Fixators ; Female ; Follow-Up Studies ; Fractures, Comminuted ; Fractures, Ununited ; Humans ; Immobilization ; Male ; Neurologic Manifestations ; Odontoid Process ; Retrospective Studies ; Risk Factors ; Spinal Fractures

OBJECTIVE: Both of ossification of posterior longitudinal ligament (OPLL) and cervical spondylotic myelopathy (CSM) could be treated by cervical laminoplasty. In this study we compared long-term clinical and radiological outcomes in these two disease entities, treated with modified midline splitting laminoplasty (MSL). METHODS: We retrospectively analyzed the outcomes of 21 consecutive cervical myelopathy patients (13 OPLL and 8 CSM) who underwent modified MSL between 2004 and 2008. The mean follow-up duration was 49.5 months. The clinical outcomes were evaluated by the Japanese Orthopedic Association (JOA) score and the radiologic outcomes included the change of cervical lordosis, range of motion (ROM) and spinal canal dimension. RESULTS: The mean JOA scores of overall patient changed from 6.9 to 11.9, resulting in mean calculated recovery rates of 42.3%. The recovery rates of each group was 38.0% in the CSM group and 45.5% in the OPLL group, respectively (p=0.45). The mean cervical lordosis changed from 12.5 to 10.75 degrees in the CSM group and from 11.76 to 9.84 degrees in the OPLL group (p=0.79). The mean cervical ROM changed from 26 to 24.2 degrees in the CSM group and from 28.7 to 26.3 degrees in the OPLL group (p=0.78). The mean canal dimension changed from 201.1 to 285.0 mm2 in the CSM group and from 198.5 to 284.7 mm2 in the OPLL group (p=0.86). CONCLUSION: In the present study, all patients showed good long-term clinical outcomes by modified MSL. No significant clinical and radiographic difference of two disease entities in the same procedure was revealed.
Animals ; Asian Continental Ancestry Group ; Cervical Vertebrae ; Female ; Follow-Up Studies ; Humans ; Lordosis ; Orthopedics ; Ossification of Posterior Longitudinal Ligament ; Range of Motion, Articular ; Retrospective Studies ; Spinal Canal ; Spinal Cord Diseases

BACKGROUND: Beta-adrenergic receptor Kinase 1(betaARK1) is a serine/threonine kinase attached, which inhibits the coupling of beta-adrenergic receptor with G-protein. Myocardial betaARK1 level is usually elevated in heart failure and hypertrophy, but it is not known whether the circulating betaARK1 level is related with the degree of cardiac hypertrophy. This study was performed to evaluate the association of the betaARK1 level in circulating mononuclear leukocytes(MNL) in untreated hypertension with left ventricular mass in hypertensive patients. Method: Nineteen non-treated hypertensive patients were included for this study. High blood pressure was confirmed when systolic BP is over 150 mmHg or diastoli BP is over 95 mmHg. Echocardiography was performed to evaluate the degree of hypertrophy by measuring the left ventricular mass index(LVMI) and relative wall thickness(RWT), and test the LV function by measuring the ejection fraction(EF) according to ASE guideline. At the same time, blood was collected from each patient and MNL were isolated by gradient centrifuge with Ficoll-400. Total RNA was purified from MNL and semi-quantitative RT-PCR was performed. After reverse transcription, PCR was done with primers for human betaARK1 and GAPDH as external control. betaARK1 levels were expressed by ratio to GAPDH level and estimated the relations with clinical and Echocardiographic parameters. Result: We studied confirmed 19 hypertensive patients(10 men and 9 women, mean age of 50.6 years). Echocardiographically measured indices(mean+/-SD) were as follows; LVMI(137.3+/-30.6g/m2), PWT(0.53+/-0.09) and EF(54.6+/-8.5%). Ratio of betaARK1 levels to GAPDH was from 0.10 to 0.96 (0.62+/-0.25). betaARK1 levels were correlated with LVMI(correlation coefficient: r=.502, p=.029) and RWT(r=.627, p=.004). But Systolic BP(r=0.009, p=.93), diastolic BP(r=.07, p=.85) or EF(r=.045, p=.84) were not related to level of betaARK1. CONCLUSIONS: The betaARK1 level of circulating MNL was correlated well with the degree of the cardiac hypertrophy estimated by LVMI and RWT. This data suggests that activation of sympatho-adrenal system would exert a major role in developing cardiac hypertrophy and we can expect the decreased responsiveness to catecholamine in the heart of hypertensive patients. betaARK1 in circulating MNL might be used as a predictor or marker for LV hypertrophy in hypertensive patients.
beta-Adrenergic Receptor Kinases ; Cardiomegaly ; Echocardiography ; Female ; GTP-Binding Proteins ; Heart ; Heart Failure ; Humans ; Hypertension ; Hypertrophy ; Leukocytes, Mononuclear* ; Male ; Phosphotransferases ; Polymerase Chain Reaction ; Reverse Transcription ; RNA

In 1960 Martin and his associates described another type of tumor of the stomach derived from the smooth muscle, which they named myoid tumor in a study of six patients. In 1962 Stout applied the term "lelomyoblastoma" to this interesting entity in a report of a collected series of 69 patients. Tumor cells are round or polygonal epithelioid cells, which contain perinuclear vacuole or clear zone. A 58 year-old female was admitted to this hospital because of epigastric discomfort for three months. At Upper gastrointestinal series and gastrofiberscope, a round hemispherical submucosal tumor was noted at posterior wall near the lesser curvature of gastric antrum. After subtotal gastrectomy, the submucosal tumor was diagnosed as leiomyoblastoma. Because leiomyoblastoma are rare and easily misdiagnosed as leiomyoma or leiomyosarcoma, careful histologic study is recommended.
Epithelioid Cells ; Female ; Gastrectomy ; Humans ; Leiomyoma ; Leiomyoma, Epithelioid* ; Leiomyosarcoma ; Middle Aged ; Muscle, Smooth ; Pyloric Antrum ; Stomach* ; Vacuoles

BACKGROUND: Enterotoxigenic Escherichia coli (ETEC) has been well known pathogen as a cause of travelers' diarrhea. Nowadays, however, ETEC is also increasingly recognized as the cause of foodborne or waterborne outbreaks. We investigated an outbreak of a high school in Gwangju metropolitan city to trace the source of infection and the mode of transmission of ETEC. MATERIALS AND METHODS: All symptomatic persons were interviewed and filled out the questionnaires. We surveyed their clinical symptoms and the foods that they ate. We checked the facilities of the school, dinning room and water supply system. Microbiologic examination were carried out on above symptomatic persons and many environmental specimens. All gathered samples were examined in Gwangju city Health & Environment Research Institute. ETEC isolates were submitted to Korea Center for Disease Control and Prevention (KCDC) for Pulsed-field gel electrophoresis (PFGE). We also requested water quality analysis of water samples to Waterworks Research Institute. RESULTS: The 39 students and one sibling who visited and ate school meal showed symptoms. All staffs and cooks showed no symptom. Among 51 stool specimens, ETEC was isolated from 19 (18: students, 1:cook). ETEC was also isolated from specimens from a purifier and a water tap of the dinning room and water tank (underground water). In PFGE test, isolates from 18 persons showed identical pattern, but the PFGE patterns from water were different. Isolates of water samples showed different PFGE patterns even within the same sample. Investigation of the water distribution system revealed that contaminated underground water had been supplied to the dinning room and students of the school were exposed to it. CONCLUSION: This is the outbreak of ETEC infection occurred in a high school. Besides students, ETEC was also isolated from water samples. Considering some epidemiologic features, we suspect the mode of transmission may be waterborne despite the inconsistent PFGE results.
Academies and Institutes ; Centers for Disease Control and Prevention (U.S.) ; Diarrhea ; Disease Outbreaks ; Electrophoresis, Gel, Pulsed-Field ; Enterotoxigenic Escherichia coli* ; Groundwater ; Gwangju ; Humans ; Korea ; Meals ; Siblings ; Water ; Water Quality ; Water Supply ; Surveys and Questionnaires

BACKGROUND: Enterotoxigenic Escherichia coli (ETEC) has been well known pathogen as a cause of travelers' diarrhea. Nowadays, however, ETEC is also increasingly recognized as the cause of foodborne or waterborne outbreaks. We investigated an outbreak of a high school in Gwangju metropolitan city to trace the source of infection and the mode of transmission of ETEC. MATERIALS AND METHODS: All symptomatic persons were interviewed and filled out the questionnaires. We surveyed their clinical symptoms and the foods that they ate. We checked the facilities of the school, dinning room and water supply system. Microbiologic examination were carried out on above symptomatic persons and many environmental specimens. All gathered samples were examined in Gwangju city Health & Environment Research Institute. ETEC isolates were submitted to Korea Center for Disease Control and Prevention (KCDC) for Pulsed-field gel electrophoresis (PFGE). We also requested water quality analysis of water samples to Waterworks Research Institute. RESULTS: The 39 students and one sibling who visited and ate school meal showed symptoms. All staffs and cooks showed no symptom. Among 51 stool specimens, ETEC was isolated from 19 (18: students, 1:cook). ETEC was also isolated from specimens from a purifier and a water tap of the dinning room and water tank (underground water). In PFGE test, isolates from 18 persons showed identical pattern, but the PFGE patterns from water were different. Isolates of water samples showed different PFGE patterns even within the same sample. Investigation of the water distribution system revealed that contaminated underground water had been supplied to the dinning room and students of the school were exposed to it. CONCLUSION: This is the outbreak of ETEC infection occurred in a high school. Besides students, ETEC was also isolated from water samples. Considering some epidemiologic features, we suspect the mode of transmission may be waterborne despite the inconsistent PFGE results.
Academies and Institutes ; Centers for Disease Control and Prevention (U.S.) ; Diarrhea ; Disease Outbreaks ; Electrophoresis, Gel, Pulsed-Field ; Enterotoxigenic Escherichia coli* ; Groundwater ; Gwangju ; Humans ; Korea ; Meals ; Siblings ; Water ; Water Quality ; Water Supply ; Surveys and Questionnaires

No abstract available.
Aneurysm* ; Atrial Appendage*