BACKGROUND: At least 30 per cent of diabetics, which is said to comprise over 3% of general population in Korea, have one or more cutaneous complications during the course of the disease. These skin changes may be the consequences of microangiopathy, arteriosclerosis, direct metabolic disturbances and/or the sequelae of chronic therapy. OBJECTIVE: We tried to observe certain cutaneous and nail changes in diabetics and to relate them with systemic complications, blood sugar level and duration of diabetes. METHODS: During the period of 12 months from March, 1992 to February, 1993, a total of 1858 outpatients diagnosed as diabetes mellitus at Eulji General Hospital were examined. RESULTS: The cutaneous manifestations are observed in 79.5% of diabetics examined and cutaneous infections are the most prevalent(52.3%). Pruritus(p<0.01), anogenital pruritus(p<0.01), peripheral dedema(p<0.05) are more common in females and infections, shin spots, finger pebbles(p<0.01) are more common in males. Systemic complications are observed in 50.7% and the cutaneous manifestations are observed more frequently in patients with systemic complications(p<0.05). Shin spots, diabetic foot, peripneral edema diabetic bullosis are observed frequently associated with systemic microangiopathic complications such as retinopathy, nephropathy and neuropathy(p<0.01). There is a significant correlation between blood sugar level and fungal infections and anogenital pruritus(p<0.01). The frequencies of shin spots, diabetic foot and diabetic bullosis increase with the length of time diabetes has been present. Nail changes are observed in 39.6% of diabetics and onychomycosis is the most frequent(34.5%). CONCLUSION: It is suggested that cutaneous shgns especially fungal infections in diabetics are on the increase in Korea. A variety of skin conditions are encountered with diabetes mellitus and the dermatologist may be able to make a significant contribution in the control of diabetes mellitus by identifying skin signs and conditions as diabetic complications.
Arteriosclerosis ; Blood Glucose ; Diabetes Complications ; Diabetes Mellitus* ; Diabetic Foot ; Edema ; Female ; Fingers ; Hospitals, General ; Humans ; Korea ; Male ; Onychomycosis ; Outpatients ; Skin

We report a case of occupational asthma caused by cobalt associated with systemic symptoms. He was a non-atopic, ex-smoker and had worked in a glassware factory for 14 months. A skin prick test with CoSO4 up to 100 mg/ml showed a negative result. A bronchoprovocation test with CoSO4 demonstrated an isolated asthmatic response with systemic symptoms such as fever, arthralgia and myalgia. Although an initial methacholine bronchial challenge test showed a negative result, the following methacholine bronchial challenge test which was done 24 hours after the challenge testing demonstrated an increased airway hyperresponsiveness at 2.5 mg/ml which recovered 7 days later. An intradermal skin test with 10 mg/ml and 100 mg/ml CoSO4 solution demonstrated positive responses respectively(13 x 12/40 x 32, 20 x 15/40 x 37 (mm), histamine 16 x 14/64 x 50). A patch test including cobalt showed a negative result. Bronchoalveolar lavage fluid after the cobalt inhalation testing and other laboratory findings showed no evidence of hypersensitivity pneumonitis. These results suggested that cobalt could induce occupational asthma with systemic illness in an exposed worker.
Alveolitis, Extrinsic Allergic/chemically induced ; Asthma/*chemically induced ; Case Report ; Cobalt/*adverse effects ; Human ; Male ; Middle Age ; *Occupational Exposure ; Respiratory Function Tests

No abstract available.
Abducens Nerve Diseases* ; Abducens Nerve* ; Fistula*

PURPOSE: The human fetus is primarily dependent on the placenta for its nutrition. However, as the fetus matures, it swallows increasing amounts of amniotic fluid, which contributes to the growth of fetus. Accordingly fetuses with congenital obstruction of the gut at high level have a reduced capacity for intestinal absorption of amniotic fluid. We undertook a study to investigate the effect of congenital gut obstruction on fetal growth. METHOD: A retrospective review of the records of all patients presenting congenital gut obstruction over 6-year period (from 1992 to 1997) in Chung-ang Gil hospital was performed. Patients with a complete proximal obstruction were included in group A; patients with incomplete or lower obstruction were included in group B. RESULT: 1) The ratio of male to female was 1.5:1. The mean birth weight and gestational age were 2.89+/-0.60kg and 38.7+/-0.20weeks. The mean birth weight and gestational age in group A were 2.68+/-0.69kg and 37.8+/-0.25weeks. The mean birth weight and gesnal age in group B were 2.980.54kg and 39.1+0.17weeks. There was significant difference between group A and B (P<0.01). 2) Significant differences were found between group A and B in prematurity and growth retardation rate (P<0.01). No significant difference was found between group A and B in associated anomaly rate (P>0.05). 3) In group A, 3 (42.8%) of 7 patients with associated anomalies had IUGR, whereas 8 (40.0%) of 20 patients without associated anomalies had IUGR (P>0.05). The corresponding figures for group B were 23.0% and 14.8%, respectively (P>0.05). CONCLUSION: Congenital gut obstruction causes IUGR by reducing intestinal absorption of amniotic fluid and the effect of IUGR is more pronounced as the obstruction is proximal to jejunum rather than distal to it.
Amniotic Fluid ; Birth Weight ; Female ; Fetal Development* ; Fetal Growth Retardation ; Fetus ; Gestational Age ; Humans ; Intestinal Absorption ; Jejunum ; Male ; Placenta ; Retrospective Studies ; Swallows

No abstract available.
Enoxacin* ; Humans ; Male* ; Urethritis*

The diaphragm is especially important in sustaining minute ventilation in the neonate. Consequently, diaphragmatic paralysis is not tolerated well by the neonate and often results in prolonged respiratory failure. We experienced a case of unilateral diaphragmatic paralysis with the brachial plexus palsy in a male newborn infant who presented with apnea and cyanosis due to birth asphyxia. After endotracheal intubation, mechanical ventilaton was started. At two weeks after therapy, chest X-ray showed atelectasis and elevation of the right hemidiaphragm. The diagnosis of unilateral diaphragmatic paralysis was confirmed by real-time ultrasonography. At 4 weeks old, after several unsuccessful attempts at weaning from ventilatory support, right hemidiaphragm was plicated. On the second postoperative day, he could be weaned from ventiatory support without difficulty. He was doing well at follow-up 3 months later.
Apnea ; Asphyxia ; Brachial Plexus* ; Cyanosis ; Diagnosis ; Diaphragm ; Follow-Up Studies ; Humans ; Infant, Newborn* ; Intubation, Intratracheal ; Male ; Paralysis* ; Parturition ; Pulmonary Atelectasis ; Respiratory Insufficiency ; Respiratory Paralysis* ; Thorax ; Ultrasonography ; Ventilation ; Weaning

No abstract available.
Arteriovenous Fistula* ; Laminectomy*

PURPOSE: As Parkinson's disease (PD) can be considered a network abnormality, the effects of deep brain stimulation (DBS) need to be investigated in the aspect of networks. This study aimed to examine how DBS of the bilateral subthalamic nucleus (STN) affects the motor networks of patients with idiopathic PD during motor performance and to show the feasibility of the network analysis using cross-sectional positron emission tomography (PET) images in DBS studies. MATERIALS AND METHODS: We obtained [15O]H2O PET images from ten patients with PD during a sequential finger-to-thumb opposition task and during the resting state, with DBS-On and DBS-Off at STN. To identify the alteration of motor networks in PD and their changes due to STN-DBS, we applied independent component analysis (ICA) to all the cross-sectional PET images. We analysed the strength of each component according to DBS effects, task effects and interaction effects. RESULTS: ICA blindly decomposed components of functionally associated distributed clusters, which were comparable to the results of univariate statistical parametric mapping. ICA further revealed that STN-DBS modifies usage-strengths of components corresponding to the basal ganglia-thalamo-cortical circuits in PD patients by increasing the hypoactive basal ganglia and by suppressing the hyperactive cortical motor areas, ventrolateral thalamus and cerebellum. CONCLUSION: Our results suggest that STN-DBS may affect not only the abnormal local activity, but also alter brain networks in patients with PD. This study also demonstrated the usefulness of ICA for cross-sectional PET data to reveal network modifications due to DBS, which was not observable using the subtraction method.
Aged ; Brain/*radionuclide imaging ; Cross-Sectional Studies ; Deep Brain Stimulation/*methods ; Female ; Functional Laterality/*physiology ; Humans ; Male ; Middle Aged ; Parkinson Disease/radionuclide imaging/*therapy ; Positron-Emission Tomography ; Severity of Illness Index ; Subthalamic Nucleus/*physiopathology

BACKGROUND AND OBJECTIVES: No existing device for cardiopulmonary resuscitation(CPR)isdesignedto exploit both the "cardiac pump" and the "thoracic pump" simultaneously. This study was designed to assess the hemodynamic effects of simultaneous sterno-thoracic CPR (SST-CPR) vs. standard CPR (S-CPR) using a mechanical resuscitator in a canine model of cardiac arrest. DEVICE DESCRIPTION: We have built a device that depresses the sternum and circumferentially constricts the thorax simultaneously. This device has two components. The first component is a piston, which depresses the sternum. The second is a circumferential strap that constricts the thorax as the piston is pushed down on the sternum. MATERIALS AND METHODS: Twelve domestic dogs were enrolled in this study. After catheterizations to measure pressures from the aorta and the right atrium, ventricular fibrillation was induced by passing AC current to the right ventricle. After 4 minutes of cardiac arrest, S-CPR and SST-CPR were performed alternatively. Aortic pressure, right atrial pressure, cardiac output, and end tidal CO2 were measured while each method of CPR was performing. RESULTS: SST-CPR resulted in significantly higher mean arterial pressure than S-CPR (68.9+/-16.1 vs 30.5+/-10.0 mmHg, p<0.01). SST-CPR could generate higher coronary perfusion pressure than S-CPR (47.0+/-11.4 vs 17.3+/-8.9 mmHg, p<0.01). End tidal CO2 tension was also higher during SST-CPR than S-CPR (11.6+/-6.1 vs 2.17+/-3.3 mmHg, p<0.01). CONCLUSION: Simultaneous sternothoracic cardiopulmonary resuscitation is a new method of cardiopulmonary resuscitation, which can generate better hemodynamic effects than standard cardiopulmonary resuscitation.
Animals ; Aorta ; Arterial Pressure ; Atrial Pressure ; Cardiac Output ; Cardiopulmonary Resuscitation* ; Catheterization ; Catheters ; Dogs ; Heart Arrest* ; Heart Atria ; Heart Ventricles ; Hemodynamics* ; Perfusion ; Sternum ; Thorax ; Ventricular Fibrillation

BACKGROUND AND OBJECTIVES: No existing device for cardiopulmonary resuscitation(CPR)isdesignedto exploit both the "cardiac pump" and the "thoracic pump" simultaneously. This study was designed to assess the hemodynamic effects of simultaneous sterno-thoracic CPR (SST-CPR) vs. standard CPR (S-CPR) using a mechanical resuscitator in a canine model of cardiac arrest. DEVICE DESCRIPTION: We have built a device that depresses the sternum and circumferentially constricts the thorax simultaneously. This device has two components. The first component is a piston, which depresses the sternum. The second is a circumferential strap that constricts the thorax as the piston is pushed down on the sternum. MATERIALS AND METHODS: Twelve domestic dogs were enrolled in this study. After catheterizations to measure pressures from the aorta and the right atrium, ventricular fibrillation was induced by passing AC current to the right ventricle. After 4 minutes of cardiac arrest, S-CPR and SST-CPR were performed alternatively. Aortic pressure, right atrial pressure, cardiac output, and end tidal CO2 were measured while each method of CPR was performing. RESULTS: SST-CPR resulted in significantly higher mean arterial pressure than S-CPR (68.9+/-16.1 vs 30.5+/-10.0 mmHg, p<0.01). SST-CPR could generate higher coronary perfusion pressure than S-CPR (47.0+/-11.4 vs 17.3+/-8.9 mmHg, p<0.01). End tidal CO2 tension was also higher during SST-CPR than S-CPR (11.6+/-6.1 vs 2.17+/-3.3 mmHg, p<0.01). CONCLUSION: Simultaneous sternothoracic cardiopulmonary resuscitation is a new method of cardiopulmonary resuscitation, which can generate better hemodynamic effects than standard cardiopulmonary resuscitation.
Animals ; Aorta ; Arterial Pressure ; Atrial Pressure ; Cardiac Output ; Cardiopulmonary Resuscitation* ; Catheterization ; Catheters ; Dogs ; Heart Arrest* ; Heart Atria ; Heart Ventricles ; Hemodynamics* ; Perfusion ; Sternum ; Thorax ; Ventricular Fibrillation