Body surface potential map, an electric potential distribution on the body torso surface, enables us to infer the electrical activities of the heart. Therefore, observing electric potential projected to the torso surface can be highly useful for diagnosing heart diseases such as coronary occlusion. The BSPM for the heart of a patient show a higher level of sensitivity than 12-lead ECG. Relevant research has been mostly based on clinical statistics obtained from patients, and, therefore, a simulation for a variety of pathological phenomena of the heart is required. In this study, by using computer simulation, a body surface potential map was implemented according to various occlusion locations (distal, mid, proximal occlusion) in the left anterior descending coronary artery. Electrophysiological characteristics of the body surface during the ST segment period were observed and analyzed based on an ST isointegral map. We developed an integrated system that takes into account the cellular to organ levels, and performed simulation regarding the electrophysiological phenomena of the heart that occur during the first 5 minutes (stage 1) and 10 minutes (stage 2) after commencement of coronary occlusion. Subsequently, we calculated the bipolar angle and amplitude of the ST isointegral map, and observed the correlation between the relevant characteristics and the location of coronary occlusion. In the result, in the ventricle model during the stage 1, a wider area of ischemia led to counterclockwise rotation of the bipolar angle; and, during the stage 2, the amplitude increased when the ischemia area exceeded a certain size.
Cardiac Electrophysiology* ; Computer Simulation* ; Coronary Occlusion ; Coronary Vessels* ; Electrocardiography ; Electrophysiological Phenomena ; Electrophysiology ; Heart ; Heart Diseases ; Humans ; Ischemia ; Torso

Primary ovarian transitional cell carcinoma(TCC) is a recently described, distinct subtype of ovarian carcinoma resembling TCC of the urinary bladder. TCC differs from malignant Brenner tumor(MBT) by absence of benign or proliferative Brenner component and prominent stromal calcification. TCC also represents a high-stage tumor with more aggressive biologic behavior than MBT, but it has a relatively favorable response to chemotherapy. TCC may arise from the pluripotential surface epithelium of the ovary or from the cells with urothelial differentiation, rather than from a benign or proliferative Brenner tumor precursors. We report a case of pure form of primary TCC presenting as a left ovarian mass in 45-year-old woman.
Female ; Humans

This analysis was performed to investigate the relationship between nutrition and anthropometric indices using the data from a cross-sectional survey of a large national sample, '98 Korean national health and nutrition examination survey. Subjects were selected by stratified multistage probability sampling design and completed dietary questionnares including food intakes for one day by 24-hour recall method. For this analysis, 6566 subjects were selected by age(over 20 years old). For anthropometry, height, weight, and waist- and hip- circumference were measured. They were classified by body mass index(BMI, weight(Kg)/height2(m2)) and waist-hip ratio(WHR, waist circumference(Cm)/hip circumference(Cm)). The nutrients intake of subjects were compared with the recommended daily allowances(RDA). Mean adequacy ratio(MAR) was calculated. Mean heights, weights, BMIs were higher in the groups with nutrient intake over 125% of RDA than the lower intake groups for most nutrients. However, Mean WHR was the highest in the groups with nutrient intake under 75% of RDA for most nutrients excluding iron intake of women aged 20~64 years. Among women aged 20~64 years, means of MAR were 0.71 for obese individuals(BMI>30), 0.72 for subjects with underweight(BMI<18.5), and 0.76 for subjects with normal weight(18.5< or = BMI<25). Normal subjects has statistically significantly higher MAR than those of other groups. However, among elderly people aged over 65 years, obese group had the highest MAR, 0.68. Women with abdominal obesity(WHR>0.9) had lower MAR, 0.71 than those with normal weight(MAR=0.76). From these results, obesity and abdominal obesity seems to be the results of malnutrition including both undernutrition and overnutrition rather than simple problem of excess energy intake. Obesity in elderly people needs to be handled differently from adults.
Adult ; Aged ; Anthropometry ; Cross-Sectional Studies ; Energy Intake ; Female ; Humans ; Iron ; Malnutrition ; Nutrition Surveys* ; Obesity ; Obesity, Abdominal ; Overnutrition ; Weights and Measures

This analysis was performed to investigate the relationship between nutrition and anthropometric indices using the data from a cross-sectional survey of a large national sample, '98 Korean national health and nutrition examination survey. Subjects were selected by stratified multistage probability sampling design and completed dietary questionnares including food intakes for one day by 24-hour recall method. For this analysis, 6566 subjects were selected by age(over 20 years old). For anthropometry, height, weight, and waist- and hip- circumference were measured. They were classified by body mass index(BMI, weight(Kg)/height2(m2)) and waist-hip ratio(WHR, waist circumference(Cm)/hip circumference(Cm)). The nutrients intake of subjects were compared with the recommended daily allowances(RDA). Mean adequacy ratio(MAR) was calculated. Mean heights, weights, BMIs were higher in the groups with nutrient intake over 125% of RDA than the lower intake groups for most nutrients. However, Mean WHR was the highest in the groups with nutrient intake under 75% of RDA for most nutrients excluding iron intake of women aged 20~64 years. Among women aged 20~64 years, means of MAR were 0.71 for obese individuals(BMI>30), 0.72 for subjects with underweight(BMI<18.5), and 0.76 for subjects with normal weight(18.5< or = BMI<25). Normal subjects has statistically significantly higher MAR than those of other groups. However, among elderly people aged over 65 years, obese group had the highest MAR, 0.68. Women with abdominal obesity(WHR>0.9) had lower MAR, 0.71 than those with normal weight(MAR=0.76). From these results, obesity and abdominal obesity seems to be the results of malnutrition including both undernutrition and overnutrition rather than simple problem of excess energy intake. Obesity in elderly people needs to be handled differently from adults.
Adult ; Aged ; Anthropometry ; Cross-Sectional Studies ; Energy Intake ; Female ; Humans ; Iron ; Malnutrition ; Nutrition Surveys* ; Obesity ; Obesity, Abdominal ; Overnutrition ; Weights and Measures

OBJECTIVE: To find out the factors affecting medication discontinuation in patients with overactive bladder (OAB) symptoms. METHODS: The clinical data of 125 patients with OAB symptoms who had taken antimuscarinics and behavioral therapy were retrospectively reviewed. Antimuscarinics related outcomes were evaluated by an independent observer with telephone interview. All patients were asked about duration of medication and reason of continuation or discontinuation of antimuscarinics. To determine pre-treatment factors predicting self-report discontinuation of antimuscarinics, variables of only those with P-values <0.25 on the univariate analysis were included in the Cox proportional hazard modeling. RESULTS: Mean follow-up was 39.6 months and the proportion of discontinuation of antimuscarinics was 60.0% (75/125). The mean duration of medication was 21.2 months in the continuation group and 3.3 months in the discontinuation group. The reasons of discontinuation of antimuscarinics were improved OAB symptoms (46.7%), tolerable OAB symptoms (33.3%), no change of OAB symptoms (1.3%), side-effects (8.0%) and no desire to take long-term medication (10.7%). The variables affecting remaining cumulative probability of antimuscarinics were age, history of anti-incontinence surgery or vaginal surgery, and having stress predominant urinary incontinence on urodynamic study. CONCLUSION: The lower rate of cumulative continuation of antimuscarinics encourages us to give a more detailed counseling and education to the patients with OAB symptoms before prescription. And explorations about newer agent and non-pharmacologic treatment with good efficacy and lower side-effects are needed.
Counseling ; Education ; Follow-Up Studies ; Humans ; Interviews as Topic ; Muscarinic Antagonists ; Prescriptions ; Proportional Hazards Models ; Retrospective Studies ; Urinary Bladder, Overactive* ; Urinary Incontinence ; Urodynamics

BACKGROUND: The incidence of fungal urinary tract infections has increased in the immunocompromized patients. We analyzed urine culture results of St. Mary's Hospital during 28 month period between October 1993 and January 1996 to evaluate the frequency of yeast isolates and to survey the distribution of departments from where yeasts isolated. METHODS: We performed a retrospective analysis of urine culture results. Yeasts were identified by the examination of germ tube production in human serum at 37degrees C and API2OC (BioMerieux, France) yeast strip. RESULT: A total of 1,387 urine cultures were reviewed, of which 164 (11.8%) were isolated as fungi. Candida albicans occurred in 36.5% of the total yeast isolates, C. tropicalis in 35.3%, C. glabrata in 10.9% and Trichosporon beigelii in 0.6%. The incidence of urinary fungal infection increased in 1995 (13.0%) than 1994 (9.1%) (P=0.047). Fifty two percents (85/164) of urinary fungi were isolated from patients in Neurosurgery (NS), where isolation of C. tropicalis was significantly more increased than other departments. In four patients, candiduria progressed to candidemia, which were caused by C. albicans (three patients) and C. glabrata (1 patient). CONCLUSIONS: The isolation rate of yeast species was different in NS and non-NS department. The frequency of isolation of C. albicans increased in non-NS department than NS department, while the frequency of isolation of C. tropicalis increased in NS department than non-NS department. The most common organism was C. albicans and department was Neurosurgery.
Candida albicans ; Candidemia ; Fungemia ; Fungi ; Humans ; Incidence ; Neurosurgery ; Retrospective Studies* ; Trichosporon ; Urinary Tract Infections ; Yeasts

We performed dual color fluorescence in situ hybridization (FISH) for the bcr/abl fusion in CML using the peripheral blood smears without destruction of cell morphology to determine the bcr/abl fusion. Two patients of CML, one patient in accelerated phase and one patient in chronic phase, were selected. The blood smears were fixed in absolute methanol. FISH was performed with the Mbcr/abl translocation DNA probe mixture and the slides were stained with Wright's stain after FISH. The blood smears of both cases revealed distinct signals without destruction of cellular morphology. The normoblasts and lymphocytes revealed beautiful fused bcr/abl signals as well as granulocytes in both cases. The results provide a novel finding that the normoblasts and lymphocytes in CML are also neoplastic clonal cells which has not been demonstrated with a single-cell approach before.
DNA ; Erythroblasts* ; Fluorescence* ; Granulocytes ; Humans ; In Situ Hybridization ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive* ; Lymphocytes* ; Methanol

Acute peripheral vestibulopathy, of which the chief complaint is positional vertigo, comprises benign paroxysmal positional vertigo (BPPV), labyrinthitis, labyrinthine fistula, and cerebellopontine angle tumors. Since the typical presentation of labyrinthine fistulas may be sensorineural hearing loss, positional vertigo, or disequilibrium, it is often difficult to distinguish from BPPV or Meniere's disease. Herein we report a 61-year-old female patient with typical symptoms and signs attributable to geotropic type variant of the lateral semicircular canal BPPV on the left side, who eventually was confirmed as having a labyrinthine fistula from chronic otitis media with cholesteatoma on the left side. This is another case where, even in the presence of isolated vertigo showing typical findings of acute peripheral vestibulopathy, other otologic symptoms and signs must not be overlooked.
Cholesteatoma* ; Ear, Inner ; Female ; Fistula* ; Hearing Loss, Sensorineural ; Humans ; Labyrinthitis ; Meniere Disease ; Middle Aged ; Neuroma, Acoustic ; Otitis Media ; Semicircular Canals ; Vertigo* ; Vestibular Neuronitis

Regarding therapies for treatment of corneal wounds, ex vivo corneal culture is the most effective for minimizing expensive animal studies. Eighteen porcine enucleated eyes were soaked in 0.2% povidone iodine solution for disinfection prior to cornea excision. Subsequently, corneas were excised from whole eyes and filled with an agar/medium mixture. Corneas were transferred into culture dishes, after which culture medium was added until the limbus was covered. Cultures were then placed onto a plate rocker to mimic blinking action, followed by incubation at 37degrees C and 5% CO2. Corneas were harvested on Days 0, 3, and 7 after incubation, and optical coherence tomography (OCT) was performed on Day 7. Two eyes from each group were fixed in 2% glutaraldehyde/4% paraformaldehyde for low vacuum scanning electron microscopy (LV-SEM), and four eyes from each group were fixed in 10% neutral-buffered formalin for histological analysis. OCT results showed that central corneal thickness significantly increased by Day 7 compared to Day 0 (P<0.05). Using LV-SEM, gaps between endothelial cells were detected on Day 7 of ex vivo culture. In the histological evaluation, four to five stratified squamous cell layers, wing cells, and basal cells in the epithelium as well as flat-shaped keratocytes in the stroma were found on Day 0. By Day 7, stratified squamous cells and basal cells had decreased in number, and slightly round-shaped keratocytes were observed; however, the number of keratocytes was similar to that on Day 0. In this short-term ex vivo culture, epithelium and endothelium were sensitive to culture, whereas stroma and keratocytes were well maintained. An additional deswelling method will be needed to obtain more successful results in porcine corneal ex vivo culture.
Animals ; Blinking ; Cornea* ; Disinfection ; Endothelial Cells ; Endothelium ; Epithelium ; Formaldehyde ; Microscopy, Electron, Scanning ; Povidone-Iodine ; Tomography, Optical Coherence ; Vacuum ; Wounds and Injuries ; Wings, Animal

BACKGROUND AND OBJECTIVES: Benign paroxysmal positional vertigo (BPPV) generally involves a single semicircular canal (single canal BPPV) but it has been reported that more than one semicircular canal on either the same or the opposite side can be involved in 6.8-20% of the cases (multiple canal BPPV). In this study, the clinical characteristics of multiple canal BPPV were analyzed and compared to those of single canal BPPV. MATERIALS AND METHODS: Retrospective analysis was performed on 1054 consecutive patients diagnosed with BPPV. Multiple canal BPPV was diagnosed when the combination of typical nystagmus was provoked by the Dix-Hallpike and supine head roll tests. Canalith repositioning maneuver was performed sequentially starting with the semicircular canal causing more severe nystagmus or symptoms. Clinical characteristics and the treatment course were statistically compared between single canal BPPV and multiple canal BPPV. RESULTS: Among the 1054 patients, single canal BPPV was diagnosed in 1005 patients (95.4%) while multiple canal BPPV was diagnosed in 49 patients (4.6%). BPPV involving semicircular canals on the same side was more common (79.6%) than BPPV with bilateral involvement. The most common combination of the involved canals was ipsilateral posterior and horizontal semicircular canals (63.3%). Multiple canal BPPV was significantly more associated with underlying otologic diseases, especially labyrinthitis. Multiple canal BPPV required more treatment sessions and longer duration of treatment to achieve resolution of nystagmus and symptoms. CONCLUSIONS: As all cases of multiple canal BPPV were treated successfully although a longer duration of treatment and more treatment sessions were required compared to single canal BPPV, the results of our study could aid in making an accurate diagnosis and providing appropriate treatment of multiple canal BPPV.
Diagnosis ; Ear Diseases ; Ear, Inner ; Head ; Humans ; Labyrinthitis ; Retrospective Studies ; Semicircular Canals* ; Vertigo*