BACKGROUND AND OBJECTIVES: The simultaneous binaural bithermal caloric test is performed by stimulating both ear canals with the water of same temperature at the same time. There are some reports that the simultaneous binaural bithermal caloric test appears to be more sensitive than the alternative bithermal caloric test in detecting caloric vestibular abnormalities. However, it is not well known yet what effect simultaneous binaural bithermal caloric test has on the vestibulo-ocular reflex. We attempted to verify the clinical usefulness of the simultaneous binaural bithermal caloric test. MATERIALS AND METHODS: Otoneurologically normal subjects (n=20) and patients who have complaints of dizziness (n=141) were tested. The regular bithermal caloric test was performed, using Life-Tech water irrigator and the water of temperatures 30degreesC and 44degreesC. The simultaneous binaural bithermal test was performed using Brooker-Grams closed loop irrigator with 27degreesC and 44degreesC water. The irrigation time was 40 seconds and nystagmus was detected for more than 120 seconds by electronystagmography. We divided the test response into six types with the reference value of canal paresis (CP) of the regular bithermal caloric test. RESULTS: The distribution of nystagmus type did not show regular pattern in the normal controls. The distribution of type I and II was 77.4% when CP was more than 25% in patients, 50.6% when CP was less than 25% in patients, and 42.5% in the normal group. The maximal velocity of slow component increased in the unilateral canal paresis patients (CP>25%), compared with the normal controls and no unilateral canal paresis patients (Cp<0.05). CONCLUSION: We observed that the simultaneous binaural bithermal caloric test has advantages of being less time-consuming and more comfortable. When the maximal velocity of slow component is more than 22.6 deg/sec with type I or II response, we could predict canal paresis; however, further studies should be made for abnormal response of simultaneous caloric response on the central nervous ststem.
Caloric Tests* ; Dizziness ; Ear Canal ; Electronystagmography ; Humans ; Paresis ; Reference Values ; Reflex, Vestibulo-Ocular ; Water

No abstract available.

The use of recombinant DNA technology to produce human growth hormone has resulted in a marked increase in availability of Growth Hormone(GH) to treat short stature due to GH deficiency and other conditions, such as Turner syndrome, familial short stature, chronic renal insufficiency and intrauterine growth retardation (IUGR). But, the GH therapy may result in the adverse events such as sodium and water retention, pseudotumor cerebri, slipped capital femoral epiphysis, growth of nevi, recurrence of tumor. We experienced a case of severe hypertension associated with GH therapy in a 14-year-old male who presented high blood pressure up to 190/100 mmHg and normalized at 2-3 weeks after discontinuation of GH. Therefore, we think that the blood pressure should be carefully monitored during GH therapy.
Adolescent ; Blood Pressure ; DNA, Recombinant ; Fetal Growth Retardation ; Growth Hormone* ; Human Growth Hormone ; Humans ; Hypertension* ; Male ; Nevus ; Noonan Syndrome ; Pseudotumor Cerebri ; Recurrence ; Renal Insufficiency, Chronic ; Slipped Capital Femoral Epiphyses ; Sodium

PURPOSE: To evaluate the difference of retinal nerve fiber layer measurements as obtained by Nerve Fiber Analyser according to visual field defects in subjects with large Cup-to-Disc ratio (C/D ratio>or=0.6) and to determine which predictable parameters are useful in glaucoma diagnosis. METHODS: Fifty one normal subjects, 17 patients with glaucoma, 18 glaucoma suspects based on optic disc appearance and visual field defect participated. Nerve fiber layer thickness assessments using scanning laser polarimeter (Nerve Fiber Analyzer II software version 2.1.; Laser Diagnostic Technologies, Inc., San Diego, California, U.S.A.) were measured in normal subjects, patients with glaucoma, and glaucoma suspects. Measured nerve fiber layer thickness parameters were compared each other. RESULTS: Superior to inferior ratio (S/I ratio) was only statistically significant parameter to differentiate glaucoma from glaucoma suspects having glaucomatous optic nerve head. CONCLUSIONS: Superior to inferior ratio (S/I ratio) is useful parameter to predict differentiating patients with glaucoma from glaucoma suspects.
California ; Diagnosis ; Glaucoma* ; Humans ; Nerve Fibers* ; Optic Disk ; Retinaldehyde* ; Scanning Laser Polarimetry ; Visual Fields

Urethroplasty was done in 6 patients with posterior urethral disruption with pubectomy and end to end anastomosis or full thickness tube graft of the urethra. The following results were obtained. 1. Transpubic approach provided excellent access to posterior urethra in every case. 2. Immediate cystostomy was done in all cases and reconstruction of the urethra later. 3. One of two tube graft and three of four end to end anastomosis were successful. 4. There were no orthopedic problem, incontinence or sexual impotency.
Cystostomy ; Humans ; Orthopedics ; Transplants ; Urethra

The Radionuclide study provides reproducible information about total and differential renal function quickly and easily. The major limitation of radionuclide examination is that it does not provide a sensitive and accurate illustration of the anatomic change of the kidney but the excretory urogram provides an excellent evaluation of anatomic change in the kidney, but is a poor indicator of renal function. Therefore, the excretory urogram and renal radionuclide (rectilinear renal scanning and renogram) renal function evaluation and to discuss the result of its use comparing to 34 cases of severe abnormal anatomic change in excretory urogram. 1. The urolithiasis was 12 cases (50%) and renal tuberculosis was 7 cases (21%). 2. 18 cases (53%) was non visualization in IVP and 5 cases (28%) was maintained the renal function. The most common causes of non visualization were urolithiasis (5 cases) and renal tuberculosis (5 cases). 3. 12 cases were hydronephrosis and 6 (50%) cases were maintained good function in radionuclide study.
Hydronephrosis ; Kidney ; Tuberculosis, Renal ; Urolithiasis

PURPOSE: Not many studies have evaluated the adoption and dissemination of evidence-based medicine in rectal cancer radiotherapy (RT). We aimed to analyze the differences by institutional characteristics and geography in adopting evidence-based care for rectal cancer RT and factors affecting the adoption in Korea. MATERIALS AND METHODS: Korean National Health Insurance Service claims database was used. All rectal cancer patients treated with radical surgery and adjuvant RT at the same institution in 2005-2016 were included in this study. RT within 3 months before and after surgery was regarded as preoperative and postoperative RT, respectively. RESULTS: A total of 16,827 patients treated in 83 institutions were included in the analysis. The use of preoperative RT has substantially increased over time, from 40.6% in 2005 to 84.2% in 2016 all over the nation. The proportion of preoperative RT (54.8%) exceeded that of postoperative RT (45.2%) in 2006. However, a wide range of institutional and regional variation was observed. Compared to high-volume institutions, low-volume institutions showed late adoption and variable dissemination patterns of preoperative RT. Busan–Ulsan–Gyeongsangnam-do and Gangwon-do showed slower adoption and less use of preoperative RT than other region. CONCLUSION: We demonstrated gradual and steady increase in adoption of preoperative RT in rectal cancer treatment nationally from 2005 to 2016. Institutional variations between high- and low-volume institutions were observed.
Evidence-Based Medicine* ; Gangwon-do ; Geography ; Humans ; Korea ; National Health Programs ; Radiotherapy* ; Rectal Neoplasms*

PURPOSE: The objective of this study was to report the outcomes of patients treated with extracorporeal shock wave therapy (ESWT) for refractory plantar fasciitis of the foot. MATERIALS AND METHODS: From November 2005 to October 2006, a total of sixty-two patients with refractory plantar fasciitis were treated with extracorporeal shock wave therapy. The main outcome measurements were visual analogue scale (VAS) and Roles and Maudsley score evaluated before treatment and at one and six months after treatment. RESULTS: Roles and Maudsley score was excellent (0%), good (6.4%), fair (35.4%) and poor (58.2%) before treatment which improved to excellent (56.5%), good (38.7%), fair (4.8%) and poor (0%) at final follow-up. VAS scores also significantly improved after ESWT (p<0.05). There was no statistically significant correlation between clinical results and body mass index (BMI) (p=0.102). CONCLUSION: Extracorporeal shock wave therapy appears to be an effective and safe treatment modality for refractory plantar fasciitis and may help the patient to avoid surgery for refractory heel pain.
Body Mass Index ; Fasciitis, Plantar* ; Follow-Up Studies ; Foot ; Heel ; Humans ; Shock*

BACKGROUND: The level of physical adaptation through active lifestyle can result in changes in appetite; and caused by physical activity and exercise, physical adaptation may change carbohydrate and fat metabolism during exercise. This study investigated the differences in carbohydrate and fat metabolism after moderate treadmill running and the difference in appetite response before and after exercise in active, regularly exercising individuals and those inactive. METHODS: We analyzed the effects of moderate physical activity (70% of oxygen uptake reserve, 30 minutes on the treadmill) on free fatty acids, glucose, growth hormone, insulin and an appetite visual analogue scale (VAS). Our subjects included 28 healthy males who were divided into two groups, the activity group (n=14) and the inactivity group (n=14) according to the International Physical Activity Questionnaire (IPAQ). The serum samples and VAS were collected at pre, post and 30 min post-exercise. RESULTS: The results of the serum analysis showed no significant effects on free fatty acids, glucose, growth hormone and insulin between the groups, but showed significant changes in free fatty acids and growth hormone between points of measurement. Significant increases in VAS were seen with moderate exercise in both groups, with the inactivity group expressing greater hunger than the activity group. CONCLUSIONS: This study found that inactive persons were hungrier than active persons after moderate exercise. This information might be useful to staff and participants of weight loss programs.
Appetite ; Energy Metabolism ; Exercise ; Fatty Acids, Nonesterified ; Glucose ; Growth Hormone ; Humans ; Hunger ; Insulin ; Life Style ; Male ; Motor Activity ; Oxygen ; Running ; Weight Reduction Programs ; Surveys and Questionnaires

No abstract available.
Kidney Transplantation* ; Wegener Granulomatosis*