BACKGROUND: Dizziness is a common complaint in patients presenting at emergency departments. Dizziness is difficult to assess because it is a subjective complaint that cannot be measured. We report a clinical analysis of patients with acute dizziness: type, duration, symptom, incidence, etc. METHODS: We reviewed the clinical details and the results of vestibular function tests for 106 acutely dizzy patients who visited the Emergency Department of Wonkwang University Hospital during the period of Jul. 1999 through Dec. 1999. RESULTS: The most common etiology of acute dizziness was the peripheral vestibular system(66%). The most common disease of the peripheral vestibular system was benign paroxysmal positional vertigo(52.9%), and the second most one was vestibular neuronitis(42.9%). In the central nervous system, cerebrovascular accident(63.6%) was the most common cause. All of the patients had experienced a previous vertigo attack, and 42.4% of them had frequent attacks. Dizziness of the cochlear systems were usual in peripheral vertigo. The usual underlying diseases related with vertigo were hypertension, cerebral infarction and diabetes mellitus. CONCLUSION: Dizziness is a complex and frustrating symptom with numerous possible causes. In case with suspected central disorders, CT and MRI have a great diagnostic significance.
Central Nervous System ; Cerebral Infarction ; Diabetes Mellitus ; Dizziness* ; Emergencies* ; Emergency Service, Hospital ; Humans ; Hypertension ; Incidence ; Magnetic Resonance Imaging ; Vertigo ; Vestibular Function Tests

Eleven patients underwent posterior sagittal anorectoplasty(PSARP) as a secondary procedure. Two of them had rectovaginal fistula and another two had rectocutaneous fistula. Six of the rest complained of frequent fecal soiling and the last one had severe anorectal stricture after perineal anoplasty. Five patients had lived with colostomy until the second operations were carried out. The ages at the time of the secondary PSARP were between 7 months and 29 years. Distal colostogram and MRI were taken to evaluate distal colon, position of the rectum and voluntary muscle. All patients had normal sacrum except one who had anorectal stricture. Seven patients, six with fecal incontinence and the other one with rectovaginal fistula had mislocated anorectums. Three patients, two with rectocutaneous fistula, the other one with anorectal stricture, had abdominal approach to obtain enough length of colon for pull-through procedure. With the posterior midsagittal approach, we could manage all the problems, rectovaginal fistulas, rectocutaneous fistulas, strictures and malpositioned rectums, without difficulty. No patients had serious complications except wound infection in one. All patients were satisfied with the results after redo-PSARPs even though normal continence has been achieved in only one patient. Seven patients who had continuous soiling or rectocutaneous fistula, needed no more diapers even though four of them showed fecal staining under stressful condition and the other three showed intermittent fecal leaking less than once a day. The rest three of the patients maintained their continence with support of drugs and/or enemas because of constipation. The PSARP is a popular procedure as a primary operation; however, our results suggested that this procedure also gave us a good opportunity for management of serious complication developed after primary anoplasties.
Colon ; Colostomy ; Constipation ; Constriction, Pathologic ; Enema ; Fecal Incontinence ; Fistula ; Humans ; Magnetic Resonance Imaging ; Muscle, Skeletal ; Rectovaginal Fistula ; Rectum ; Sacrum ; Soil ; Wound Infection

Aneurysm of the splenic artery are the third most common intra-abdominal aneurysm, following aneurysms of the infrarenal aorta and iliac arteries. Splenic artery aneurysms (SAA) are the most frequent visceral artery aneurysms and account for more than two thirds of all lesions. Incidence of SAA are rare clinical entities(0.01-0.2%) that carry risk of rupture and fatal hemorrhage(35-100%). Fibroblastic dysplasia and atherosclerosis is fecund in the majority, and the fact that these aneurysms developes more commonly in female. Most patients are asymptomatic and the diagnosis is generally made incidentally. The treatment of patient with known SAA is dictated by several factors, including location, age, sex, present of symptom, size, pregnancy. We report ruptured splenic artery aneurysm with hemoperitoneum and review of the literature.
Aneurysm* ; Aorta ; Arteries ; Atherosclerosis ; Diagnosis ; Female ; Fibroblasts ; Hemoperitoneum ; Humans ; Iliac Artery ; Incidence ; Pregnancy ; Rupture ; Splenic Artery*

The effects of clonidine that is an alpha2-adrenergic agonist are complex in that the intraocular responses are biphasic and dose dependent. The mechanisms of the ocular hypotensive responses to clonidine in the treated and the contralateral untreated eyes seemed to be dependent on the central activity of clonidine and the intact peripheral adrenergic system. Apraclonidine is a clonidine derivative which penetrates into the blood-brain barrier minimally and lowers the intraocular pressure significantly not accompanied by systemic side effects such as change in blood pressure and pulse rate. The main purpose of the present study is to use apraclonidine to elucidate the influence of the central and peripheral sympathetic activity in the change of the morphology of the ciliary nonpigmented epithelium in the pigmented rabbits 0.1 cc of 1% apraclonidine was injected into the vitreous cavity of pigmented rabbits after removal of 0.1 cc of aqueous humor from the anterior chamber and the eyes were enucleated on 1, 3, 5, 7 days after injection. The eyes were observed with light microscopic examination. 1. In the 1st day's specimen, swollen nonpigmented epithelium and increased pigments were noted in the treated eye. 2. In the treated eye on the 5th day, vacuole like appearances under the nucleus of the nonpigmented epithelium were noted. 3. Except for the appearance of slightly increased pigmented granules in the 3rd and 5th day's specimen, there were no significant changes in any of the nontreated eyes. 4. The mechanism of the hypotensive response of apraclonidine seemed to be dependent on the alpha2-adrenergic receptors which are located in the eye, not on the central nor on the peripheral adrenergic system.
Anterior Chamber ; Aqueous Humor ; Blood Pressure ; Blood-Brain Barrier ; Clonidine ; Epithelium* ; Heart Rate ; Intraocular Pressure ; Intravitreal Injections* ; Rabbits* ; Vacuoles

No abstract available.
Cervical Intraepithelial Neoplasia* ; Colposcopy* ; Conization*

OBJECTIVE: Our purpose was to describe the clinical progress and the maternal and fetal outcome in 16 pregnancies complicated by the HELLP(hemolysis, elevated liver enzymes, low platelet). Material: We reviewed the maternal and neonatal charts from 16 consecutive pregnancies complicated by the HELLP syndrome among 302 pregnancies complicated by preeclamsia and eclamsia managed at our hospital during the period of 4 years from June 1994 through June 1998. The HELLP syndrome was defined by previously published laboratory criteria. We assessed the time of onset, presenting symptom, laboratory finding, mode of delivery, fetal and maternal complication in each case. We also reviewed the clinical finding in detail in the case resulted in maternal death. RESULTS: In regards to the time of onset, 15 cases (93.7%) occurred at antepartum period and only 1 case (6.2%) occurred at postpartum period. Among the 15 cases occurred at antepartum period, 13 cases (81.25%) developed at 27 to 36 weeks gestation and 2 cases (12.5%) developed at near term. In regards to the presenting symptom, twelve patients (75%) complained of right upper quardrant or epigastric pain. Of 16 patients, 12 patients (75%) experienced headache and 10 patients (62.5%) complained of nausea, or vomiting and 5 patients (31.2%) had visual disturbance. The laboratory finding of all 16 cases were as follow; the mean level of platelet: 68700/mm3 (range: 48000 to 91700), the mean level of serum asparate aminotransferase: 335 IU/L (range: 62 to 135), the mean level of lactic dehydrogenase: 910 IU/L (range: 558 to 5794), and the mean level of total bilirubin: 2.6 mg/dl (range: 0.7 to 10.4). To review the mode of delivery, cesarean sections were done on 10 patients (62.5%) including 7(43.7%) emergency and 3(18.7%) elective operations. However, 6 patients (37.5%) delivered vaginally. Maternal complications were as follow; abruptio placenta in 1 case (6.2%), DIC in 2 cases (12.5%), pulmonary edema in 3 cases (18.7%), pleural effusion in 4 cases (25%), renal failure in 4 cases (25%), and 1 case of death. Fetal and neonatal outcome was assessed; 9 cases of intrauterine growth retardation (56.2%), meconium stained in 3 cases (18.7%), 2 stillbirth (12.5%), and 2 neonatal death (12.5%). CONCLUSION: HELLP syndrome is associated with serious maternal and fetal morbidity and mortality.
Bilirubin ; Blood Platelets ; Cesarean Section ; Dacarbazine ; Emergencies ; Female ; Fetal Growth Retardation ; Headache ; HELLP Syndrome ; Hemolysis* ; Humans ; Liver* ; Maternal Death ; Meconium ; Mortality ; Nausea ; Oxidoreductases ; Placenta ; Pleural Effusion ; Postpartum Period ; Pregnancy* ; Pulmonary Edema ; Renal Insufficiency ; Stillbirth ; Vomiting

PURPOSE: This study was intended to establish experimental conditions for monitoring the cardioprotective effects of fenofibrate on cardiac function in lipopolysaccharide (LPS)-stimulated BalB/c mice. METHODS: To investigate the effects of fenofibrate on cardiac function, expression of Peroxisome proliferator-activated receptors (PPARs) and Peroxisome proliferator-activated receptor Gamma coactivator 1(PGC-1) and its target gene in the heart tissues of mice was compared after controls and LPS injection with pretreated fenofibrate or alone using reverse transcriptase-polymerase chain reaction (RT-PCR), Western blot analysis, and immunohistochemistry. In addition, Enzyme-linked-immunosorbent-assays (ELISA) were performed for assessment of pro-inflammatory cytokines of blood serum. RESULTS: Pretreated with fenofibrate had protective effects of diminishing the levels of LPS-induced pro-inflammatory cytokines, including interleukin-1beta (IL-1beta), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-alpha) and recovery from reduction of messenger Ribo-nucleic acid, protein level of PPARs and PGC-1 in LPS-administered heart tissue. In addition, increasing expression of PPARs and PGC-1 ameliorated the expression and activity of catalase blocked production of lipid peroxidation. CONCLUSION: Treatment with fenofibrate resulted in augmented expression of transcription factors and reduced production of pro-inflammatory cytokines and lipid peroxidation after LPS administration. Therefore, results of this study suggested that fenofibrate should not only have a protective effect but should also restore cardiac function in several cardiac dysfunctional situations.
Animals ; Blotting, Western ; Catalase ; Cytokines ; Fenofibrate ; Heart ; Immunohistochemistry ; Interleukin-1beta ; Interleukin-6 ; Lipid Peroxidation ; Mice ; Peroxisome Proliferator-Activated Receptors ; PPAR gamma ; Sepsis ; Transcription Factors ; Tumor Necrosis Factor-alpha

Granular cell tumors are rare disease can be which found in virtually any body site, including the tongue, skin, subcutaneous tissue, breast, rectum and vulva. However, they are rarely seen on the scalp. We report here on a rare case of granular cell tumor on the scalp. A 55-year-old woman presented with a non-tender, firm papule on the scalp. We removed the papule with excisional biopsy. Histopathologic examination showed well-circumscribed, non-capsulated nodule that consisted of large polygonal cells with abundant eosinophilic granular cytoplasms. The tumor cells were positive for S-100 protein staining. We diagnosed this case as granular cell tumor.
Biopsy ; Breast ; Cytoplasm ; Eosinophils ; Female ; Granular Cell Tumor ; Humans ; Middle Aged ; Rare Diseases ; Rectum ; S100 Proteins ; Scalp ; Skin ; Subcutaneous Tissue ; Tongue ; Vulva

PURPOSE: Traumatic brain injury is a multifaceted injury that involves direct mechanical damage, intraparenchymal and subarachnoid hemorrhage, breakdown of the blood- brain barrier, excitotoxicity, and ischemia. Despite the dozens of previous investigations, the information about its pathogenic mechanism is still limited. The aim of this study was to reveal the appearance of antigen presenting cells in the cerebral cortex of rats after cauterization. METHODS: A total of 18 male Sprague-Dawley rats weighing 300 g and 2 months old on the average were used throughout the experiment. The frontal bones were exposed by elevating the skin and craniectomies were performed adjacent to the central suture, midway between lambda and bregma. Cauterizing injury was then created by battery-operated small vessel cauterizers to the left frontal cortex. The rats were sacrificed on the 1st, 4th, 7th and 14th days after the surgery(n=3, each time), and three rats were sacrificed as normal controls. Serial brain cryosections were made by cryostat. For immunohistochemistry, brain tissue sections were allowed to react with mouse anti-rat MHC class II antibody(1:500) and mouse anti-rat ED2 antibody(1:200). Also, brain tissues were routinely stained by H-E, and then microscopic observation and cell counts were performed. RESULTS: 1) MHC class II positive dendritic cells were absent in normal cerebral cortex parenchyme, but were found 28 times more in number in injured rats on the 7th day after cauterization. 2) ED2 positive macrophages were absent in normal cerebral cortex parenchyme, and were found 16 times more in number in injured rats on the 7th day after cauterization. 3) The number of MHC class II positive dendritic cells were smaller in number than that of ED2 positive macrophages 6 hours and 1st day later after cauterization, but it was higher in number on the 4th, 7th and 14th days. 4) The number of MHC class II positive dendritic cells were higher in number than that of ED2 positive macrophages around blood vessels and peripheral regions in the injured brain. 5) MHC class II positive dendritic cells were usually aggregated. CONCLUSION: It can be suggested that the increase in number of two kinds of antigen- presenting cells affect cell-mediated immune responses and phagocytosis.
Animals ; Antigen-Presenting Cells ; Blood Vessels ; Brain ; Brain Injuries ; Cell Count ; Cerebral Cortex ; Dendritic Cells ; Frontal Bone ; Glycosaminoglycans ; Humans ; Immunohistochemistry ; Ischemia ; Macrophages ; Male ; Mice ; Rats ; Rats, Sprague-Dawley ; Skin ; Subarachnoid Hemorrhage ; Sutures

Biological diversity, also known as biodiversity, is an important criterion for measuring the value of an ecosystem. As biodiversity is closely related to human welfare and quality of life, many efforts to restore and maintain the biodiversity of species have been made by government agencies and non-governmental organizations, thereby drawing a substantial amount of international attention. In the fields of biological research, biodiversity is widely measured using traditional statistical indices such as the Shannon-Wiener index, species richness, evenness, and relative dominance of species. However, some biologists and ecologists have difficulty using these indices because they require advanced mathematical knowledge and computational techniques. Therefore, we developed VBioindex, a user-friendly program that is capable of measuring the Shannon-Wiener index, species richness, evenness, and relative dominance. VBioindex serves as an easy to use interface and visually represents the results in the form of a simple chart and in addition, VBioindex offers functions for long-term investigations of datasets using time-series analyses.
Biodiversity* ; Computational Biology ; Dataset ; Ecology ; Ecosystem ; Government Agencies ; Humans ; Quality of Life