No abstract available.
Copper* ; Female ; Humans ; Intrauterine Devices*

BACKGROUND: Because of the power of HRCT to detect the minute changes in lung parenchyme and the advantage of noninvasiveness, it may be the ideal method of follow-up evaluation of the patients with diffuse interstitial pulmonary fibrosis. So the aim of the study is to find out whether the change of HRCT during the course of the disease can represent the change in symptom and pulmonary function rest. METHODS: Thirteen patients with diagnosis of diffuse interstitial pulmonary fibrosis who had more than two times of HRCT during the course of disease were studied. The extent of the disease in HRCT was measured at three levels using image analyzer The ralationship between the percent change in the disease extent in HRCT, symptom score, and pulmonary function testis were analysed. RESULTS: The change of disease extent in HRCT has good correlation with the change in dyspnea and diffusion capacity(r=0.716, p=0.0012). But there was no correlation between the change of HRCT and FVC or TLC. Also significant inverse correlation was noted between the change in dyspnea and diffusion capacity(r=-0.707, p=0.0047). CONCLUSION: These data suggest that HRCT may be a good method of follow-up in diffuse interstitial pulmonary fibrosis.
Diagnosis ; Diffusion ; Dyspnea ; Follow-Up Studies* ; Humans ; Lung ; Pulmonary Fibrosis* ; Testis

BACKGROUND: The past. studies on prediction formulas of pulmonary function parameters in healthy nonsmoking Korean adults have been performed in relatively small number of subjects and the reported results were restricted on a few parameters. Also there was no systematic investigation into the effect of smoking on pulmonary function parameters in smokers who have no respiratory symptoms. Therefore we attempted to establish prediction formulas of pulmonary function parameters and examined the effect of smoking on pulmonary function parameters. METHODS: We analyzed the result of parameters derived from the forced expiratory spirogram in 1,067 nonsmoking subjects from June in 1990 to December in 1991. They consisted of 306 males and 761 females and had neither respiratory symptoms nor history of respiratory disease. We derived prediction formulas by multiple linear regression method from their age, heights, and weights in each sex. To examine the effect of smoking on pulmonary function parameters, we classified 383 smoking men into three groups according to the past amount of smoking as follows : i.e. group of smokers who have smoked below 10 pack-years, 10-20 pack-years and above 20 pack-years. Regarding each group of past smoking as an independent dummy variable, we analyzed pulmonary function parameters including nonsmoking men as a baseline by multiple linear regression. We evaluated the smoking effect on pulmonary function parameters according to estimated p-value. RESULT: 1) Prediction formulas for pulmonary function parameters in each sex were derived. 2) The past smoking less than 10 pack-years does not give any effect on pulmonary function parameters. The past smoking of 10~20 pack-years showed significant negative correlation with FEV1/FVC and FEF 25~75%, and the smoking above 20 pack years showed negative correlation with FEV1 and FEV1/FVC. CONCLUSION: We have got prediction formulas of pulmonary function parameters which is driven from forced expiratory spirogram in nonsmoking Korean adults by multiple linear regression from age, heights and weights of subjects. The past smoking more than 10 pack-years showed negative correlation with some pulmonary function parameters of airflow obstruction.
Adult* ; Female ; Humans ; Linear Models ; Male ; Smoke* ; Smoking* ; Weights and Measures

Objective: We studied the efficacy of the power spectral and nonspectral analysis and its diurnal variations for the early detection of the diabetic autonomic neuropathy. METHOD: The spectral and nonspectral analysis of 24hour-Holter monitoring were done for both diabetic neuropathy patients and controls. We also made a comparative analysis of the diurnal variations between the patient and control groups by means of hourly power spectral analysis. RESULT: 1) The power spectral density of the diabetic neuropathy patients was below than that of the normal controls (P<0.05) (Table 2, Fig. 1). 2) The nonspectral analysis of the diabetic neuropathy patients was below than that of the normal controls except for the mean RR intervals (P<0.05) (Table 3). 3) Every hour-power spectral analysis showed a diurnal variation of day time (06:00 to 16:00) decrease in high frequency area of the normal controls. On the contrary, there was a disappearance of the diurnal variation in patient group. CONCLUSION: The power spectral and nonspectral analyses after 24hour-Holter monitoring and its diurnal variation in the diabetic patients are considered as good means of the early detection of autonomic neuropathy, but further study of its diagnostic value will be needed.
Diabetic Neuropathies* ; Electrocardiography, Ambulatory* ; Humans

BACKGROUND: Central venous hemodialysis is often used and is respectively safe in hemodialysis patients. But, many complications have been reported. Peripheral bacteremia after insertion of central venous hemodialysis catheter is a major cause of morbidity. We undertook a prospective study to investigate the colonization of central venous hemodialysis catheter and subsequent related episodes of peripheral bacteremia. METHODS: Twenty-nine patients were enrolled ; who had been in hemodialysis program from July, 1999 to June, 2000 in Pusan National University Hospital. Blood cultures were taken from the catheter weekly after insertion. When the result of blood cultures through the central venous catheter became positive, indicating the colonization in the central venous catheter, peripheral venous blood cultures were taken before starting dialysis to detect the peripheral bacteremia. The data were analyzed by Mann-Whitney test. RESULTS: The mean age of patients was 53 years old and a prospective study of 29 central venous hemodialysis catheter was performed. Seven catheters (24%) became colonized on their instrumental surface. The mean time to colonization was 21 days after insertion. The colonizing organisms were Staphylococcus epidermidis, Staphylococcus aureus, Pseudomonas aeruginosa, Enterococcus. Four catheters (13%) developed peripheral bacteremia with the same organism of colonization in the central venous catheter. The mean time to bacteremia was 19 days after insertion. The organisms of peripheral bacteremia were Staphylococcus epidermidis (n=2), Staphylococcus aureus (1), Enterococcus (1). Bacteremia only occured when blood drawn through the catheter cultured more than 1000 colony forming units per mL. The risk of subsequent bacteremia is not related to time left in. CONCLUSION: Bacterial colonization in the central venous catheter often led to bacteremia in hemodialysis patients. The risk of subsequent bacteremia is not related to time left in situ but to degree of colonization. In future, prospective study is needed in more patients.
Bacteremia* ; Busan ; Catheterization ; Catheters* ; Central Venous Catheters ; Colon* ; Dialysis ; Enterococcus ; Humans ; Middle Aged ; Prospective Studies ; Pseudomonas aeruginosa ; Renal Dialysis* ; Staphylococcus aureus ; Staphylococcus epidermidis ; Stem Cells

BACKGROUND: It is absolutely necessary to evaluate cardiac function at starting and during hemodialysis in patients with end stage renal disease. In this study, we tried to determinate the changes of cardiac function associated with hemodialysis. METHODS: Twenty patients with end stage renal disease were enrolled , who had been in hemodialysis program from February, 1997 to August, 1999 in Pusan National University Hospital. They were examined with echocardiography and gated blood pool scintigraphy at starting hemodialysis and after follow-up. The data were analyzed by paired T-test. RESULTS: The patients were 46.2+/-16.8 years old and male to female ratio was 8 : 12. The underlying diseases were diabetes mellitus(n=10), hypertension(7), glomerulonephritis (2) and others(1). The duration of symptoms associated with end stage renal dis- ease and underlying diseases was 3.4+/-2.6 years, and the duration of hemodialysis was 13.8+/-7.0 months. The LVEDID, LVESID and RVC decreased significantly (-6.10, -7.80 and -20.00%, respectively, p<0.05) with no significant changes for LAD, IVS, PWT and EF (p>0.05). In ten cases associated with diabetes, LVEDID decreased (-7.90%, p<0.05). In twelve cases associated with cardiac diseases, LVEDID and LVESID decreased (-8.60 and -10.50%, respectively, p<0.05). In four cases associated with diabetes without cardiac diseases, LAD decreased (-5.10%, p<0.05). And in four cases associated with cardiac diseases without diabetes, there were no significant changes in cardiac dimensions and EF. In seven cases associated with diabetes and cardiac diseases, LVEDID decreased (-10.50%, p<0.05). The EF on gated blood pool scintigraphy decreased (-0.9%, p<0.05) as a whole, while increased (5.90%, p<0.05) in the cases associated with diabetes and cardiac diseases. CONCLUSION: During the early hemodialysis stage of end stage renal disease, we found a change of concentric left ventricular hypertrophy and relatively preserved left ventricular function. Furthermore we can expect that adequate hemodialysis -with dry-weight as low as possible - may prevent progression to eccentric left ventricular hypertrophy and dilated cadiomyopathy.
Busan ; Echocardiography ; Female ; Follow-Up Studies ; Gated Blood-Pool Imaging ; Glomerulonephritis ; Heart Diseases ; Humans ; Hypertrophy, Left Ventricular ; Kidney Failure, Chronic* ; Male ; Renal Dialysis* ; Ventricular Function, Left

BACKGROUND: In patients with chronic renal failure, infection is caused by altered host defense mechanism, and contributes significantly to their morbidities and mortalities. Especially, urinary tract infection often occurs in patients with chronic renal failure and is due to azotemia, infrequent voiding, low urinary flow rate and urinary concentration defects. This study was designed to compare the incidence of asymptomatic bacteriuria with chronic renal failure with that of normal control group. We also investigated whether risk factors for urinary tract infections in patients with chronic renal failure are similar to those in normal control groups. METHODS: 34 patients (M : F=13 : 21) with chronic renal failure and 30 normal control groups (M : F= 11 : 19) were evaluated in the Pusan National University Hospital from January 2001 through December 2001. Etiology of chronic renal failure included diabetes mellitus (n=16, 47.1%), hypertension (n=14, 41.2%) and glomerular diseases (n=4, 11.7%). 25 patients were treated with hemodialysis and 5 patients were treated with peritoneal dialysis. Others (n=4) were not treated with dialysis. Clean-catch, first voided urine was collected in the morning and examined by routine urinalysis and urine culture. RESULTS: 7 of 34 (20.6%) patients with chronic renal failure were positive in urine cultures and only one of 30 (3.3%) from the normal control group were positive. E. coli (n=2), Acinetobacter baumanii (n=2), Enterococcus spp. (n=2), S. aureus (n=1), P. aeruginosa (n=1), S. epidermidis (n=1) and Str. viridans (n=1) are cultured from urine specimens. There was a significant difference between the incidence of asymptomatic bacteriuria in patients with chronic renal failure and that of normal control group. But there was no significant difference in the presence of bacteriuria according to sex, age, etiology of renal failure, dialysis modality and pyuria. CONCLUSION: Patients with chronic renal failure have higher frequency of asymptomatic bacteriuria and pyuria than healthy subjects and tend to lead to symptomatic urinary tract infections.
Acinetobacter ; Azotemia ; Bacteriuria* ; Busan ; Diabetes Mellitus ; Dialysis ; Enterococcus ; Humans ; Hypertension ; Incidence ; Kidney Failure, Chronic* ; Mortality ; Peritoneal Dialysis ; Pyuria ; Renal Dialysis ; Renal Insufficiency ; Risk Factors ; Urinalysis ; Urinary Tract Infections

BACKGROUND: Henoch-Shnlein purpura is a systemic disease and has characteristic features of purpuric skin rash, abdominal pain, arthralgia and abnormal urinary findings and characterized by immunoglobulin A deposits in the involved organ. Renal involvement is the most important prognostic factor in Henoch-Shnlein purpura. METHODS: I retrospectively analyzed the clinical data of 48 patients with Henoch-Shoenlein purpura and 10 biopsy-proven Henoch-Schoenlein nephritis examined at Pusan National University Hospital. RESULTS: 23 cases were males and 25 cases females. Male to female ratio was 1:1.08. The peak of seasonal incidence was seen in spring (41.7%) and winter (27.1%) At presentation, skin purpura was present in 100% of patients, arthralgia was reported in 52.1% and gastrointestinal involvement in 70.8%. 75% of the patients showed renal involvement and pulmonary hemorrhage observed in 2 cases. Common types of skin rash were petechiae, purpura and erythematous maculopapular lesion on the lower extremities. The most common gastrointestinal symptom was abdominal pain (82.3%). Frequently involved joints were knee and ankle (48.0%). Renal involvement were microscopic hematuria (50.0%), proteinuria (50.0%), gross hematuria (29.2%). 25% of patients reached renal insufficiency (GFR<70 mL/min) and 4 cases (8.3%) reached acute renal failure (GFR<30 mL/min and anuria) and 3 patients of them experienced hemodialysis. All renal biopsies showed predominant IgA mesangial deposition. There were 2 cases of grade II, 6 cases of grade III and 2 cases of grade IV by classification of Meadow. Steroids were given in 16 patients (33.3%). Methylprednisolone pulse treatements were given in 4 patients for severe nephritis. 10 patients received angiotensin converting enzyme inhibitor. Clinical remission of extrarenal symptoms was achieved in 83.3% but relapses of purpura were observed in 27.1%. Clinical remissions of nephritis defined as the absence of proteinuria, hematuria and normal renal function was achieved in only 8.3%, Abnormal urinary finding continued in 37.8%. 8.3% of patients expired. CONCLUSION: Although it has been well known that Henoch-Shnlein purpura has benign courses, we experienced 4 case of deaths and The cause of death was acute renal faliure, pulmonary hemorrhage, adult respiratory distress syndrome, massive gastrointestinal bleeding, peritonitis due to bowel perforation.
Abdominal Pain ; Acute Kidney Injury ; Adult* ; Ankle ; Arthralgia ; Biopsy ; Busan ; Cause of Death ; Classification ; Exanthema ; Female ; Hematuria ; Hemorrhage ; Humans ; Immunoglobulin A ; Incidence ; Joints ; Knee ; Lower Extremity ; Male ; Methylprednisolone ; Nephritis ; Peptidyl-Dipeptidase A ; Peritonitis ; Proteinuria ; Purpura ; Purpura, Schoenlein-Henoch* ; Recurrence ; Renal Dialysis ; Renal Insufficiency ; Respiratory Distress Syndrome, Adult ; Retrospective Studies ; Seasons ; Skin ; Steroids

BACKGROUND: It is absolutely necessary to evaluate cardiac function on starting and during hemodialysis in patients with end stage renal disease. In this study, we tried to determinate the changes of cardiac function associated with hemodialysis. METHODS: Twenty patients with end stage renal disease, who had been in a hemodialysis program from February, 1997 to August, 1999 in Pusan National University Hospital, were enrolled. They were examined with echocardiography and gated blood pool scintigraphy on starting hemodialysis and after follow-up. The data were analyzed by paired t-test. RESULTS: The patients were 46.2 +/- 16.8 years old and male to female ratio was 8 : 12. The underlying diseases were diabetes mellitus (n=10), hypertension1), glomerulonephritis2) and others1). The duration of symptoms associated with end stage renal disease and underlying diseases was 3.4 2.6 years and the duration of hemodialysis was 13.8 7.0 months. The LVEDID, LVESID and RVC decreased significantly (-6.10, -7.80 and -20.00%, respectively, p < 0.05) with no significant changes for LAD, IVS, PWT and EF (p > 0.05). In ten cases associated with diabetes, LVEDID decreased (-7.90%, p < 0.05). In twelve cases associated with cardiac diseases, LVEDID and LVESID decreased (-8.60 and -10.50%, respectively, p < 0.05). In four cases associated with diabetes without cardiac diseases, LAD decreased (-5.10%, p 0.05) and in four cases associated with cardiac diseases without diabetes there were no significant changes in cardiac dimensions and EF. In seven cases associated with diabetes and cardiac diseases, LVEDID decreased (-10.50%, p < 0.05). The EF on gated blood pool scintigraphy decreased (-0.9%, p < 0.05) as a whole while it increased (5.90%, p < 0.05) in the cases associated with diabetes and cardiac diseases. CONCLUSION: During the early hemodialysis stage of end stage renal disease, we found a change of concentric left ventricular hypertrophy and relatively preserved left ventricular function. Furthermore, we can expect that adequate hemodialysis - with dry weight as low as possible - may prevent progression to eccentric left ventricular hypertrophy and dilated cardiomyopathy.
Adult ; Aged ; Cardiomyopathy, Congestive/prevention & control ; Diabetic Nephropathies/pathology/physiopathology/therapy ; Echocardiography ; Female ; Gated Blood-Pool Imaging ; Heart/*physiopathology ; Human ; Hypertrophy, Left Ventricular/prevention & control ; Kidney Failure, Chronic/pathology/*physiopathology/*therapy ; Male ; Middle Age ; Myocardium/pathology ; *Renal Dialysis ; Ventricular Function, Left

BACKGROUND: Myocardial perfusion scintigraphy with intravenous adenosine has proved efficacy for the diagonosis and risk stratification of coronary artery disease. To determine the safety of adenosine infusion in conjunction with radionuclide imaging, we evaluated prospectively 1,093 patients who underwent myocardial perfusion study. METHODS: Informations on safety and adverse events during and immediately after adenosine infusion were collected and statistical analysis was performed. RESULTS: The adverse events were reported in 730 patients (66.8%), but no death or myocardial infarction. There asverse events were well tolerated and no prolonged effect was noted. Chest pain occured in 223 patients(20.4%) and facial flushing and dyspnea were reported by 246 patients(22.5%) and 253 patients(23.1%), respectively. ECG changes, such as mild arrhythmia, ST depression and AV block were checked in 230 patients(21.0%). The infusion was prematurely terminated in 32 patients(2.9%), due to serve chest pain, serve brochospasm, or third degree AV block. Higher frequency of chest pain was reported in women compare to men(p<0.05), and ST segment depression was more frequent in patients with abnormal myocardial perfusion scitigraphic findings(p<0.05). CONCLUSION: These results demonstrate that intravenous infusion of adenosine is relatively safe, and myocardial perfusion scintigraphy with intravenous ademosine is feasible technique in the evaluation of the coronary artery disease patients unable to exercise.
Adenosine* ; Arrhythmias, Cardiac ; Atrioventricular Block ; Chest Pain ; Coronary Artery Disease ; Depression ; Dyspnea ; Electrocardiography ; Female ; Flushing ; Humans ; Infusions, Intravenous ; Myocardial Infarction ; Myocardial Perfusion Imaging* ; Perfusion ; Perfusion Imaging ; Prospective Studies ; Radionuclide Imaging