Minoxidil is a potent direct-acting peripheral vasodilator indicated in the management of severe or refractory hypertension. Well-known adverse effects include reflex tachycardia, fluid retention and hypertrichosis. This drug has also been reported to cause pericardial effusion in about three percent of nondialyzed patients with compromised renal function and to cause cardiac tamponade less frequently. Many studies have reported that the mean duration of therapy that caused pericardial effusion was about 8 months (range 1 month-53 months). We report a case of cardiac tamponade in nondialyzed patient with chronic renal failure receiving minoxidil for 10 years. A 58-year-old female was admitted to our hospital with dyspnea of NYHA III. She was a chronic renal failure patient without dialysis treatment and received kidney transplantation from cadaver donor and was dignosed chronic rejection in 1994. Minoxidil 10mg has been used for past 10 years. Lasix has been used for past 2 years, with dosage of 40mg to 240mg. On admission, blood pressure was 90/60mm Hg. Cardiomegaly was seen on chest radiograph. The two-dimensional echocardiogram showed a large amount of pericardial effusion. Emergency treatment with pericardiocentesis removed 2500ml of straw- colored pericardial fluid and resulted in marked improvement of dyspnea and stabilized blood pressure. The minoxidil was discontinued. The evidence of pericardial effusion was not seen for 12 months after minoxidil had been discontinued.
Blood Pressure ; Cadaver ; Cardiac Tamponade* ; Cardiomegaly ; Dialysis ; Dyspnea ; Emergency Treatment ; Female ; Furosemide ; Humans ; Hypertension ; Hypertrichosis ; Kidney Failure, Chronic* ; Kidney Transplantation ; Middle Aged ; Minoxidil* ; Pericardial Effusion ; Pericardiocentesis ; Radiography, Thoracic ; Reflex ; Tachycardia ; Tissue Donors

This study was aimed to elucidate the relationship between combinations of treadmill speed-grade and oxygen consumption(Vo2). Twenty athetic and 20 non-athletic male college students aged 19-24yr were employed to exercise on a treadmill using 4 speeds(4.02, 5.47, 6.76 and 8.05km/h) and 5 grades(0, 8, 12, 16 and 20%). A fixed speed was selected for each session with the grade increased every 3 min. The Vo2, heart rate, stride frequency and stride length were measured during the last min of each 3-min stage. Vo2increased linearly with increasing speed and grade showing significant multiple correlations in nonathletes(Vo2=3.64x+0.831y+0.031xy-7.03, R=0.98, P<0.01) and athletes(Vo2=3.48x+0.324y+0.112xy-5.74, R=0.99, P<0.01). Stride frequency and length tended to increase with increasing speed except for the transition from walking to runnig at 8.05Km/h at which the stride frequency ran up much higher with the stride length getting lower than at 6.76Km/h. Heart rate increased linearly with increasing Vo2. The rate of increase was higher during walking than during running. These results indicate that athletes have higher rate of increase in Vo2than nonathletes at near-maximal exercise and may be used as a guideline in predicting maximum oxygen comsumption and in prescribing exercise intensity.
Athletes* ; Heart Rate ; Humans ; Male ; Oxygen Consumption* ; Oxygen* ; Running ; Walking

BACKGROUND: In Korea, the effort to control the spread of severe acute respiratory syndrome (SARS) has succeeded, but we have to maintain vigilance against SARS and other infectious diseases, because many experts warn that SARS may return or that other infectious agents could spread globally. The purpose of this study is to describe the degree of knowledge of hospital employees, assuming full responsibility for treating and attending to SARS suspected case, and to elucidate the attitude to SARS using questionnaires. METHOD: All employees of Kangwon university hospital were eligible for this study. We used validated questionnaires to survey demographic characteristics, the degree of knowledge of SARS, intention of treating and attending suspected cases, influence and effects of SARS on the community, and acquisition of information about SARS. RESULT: Based on the 251 completed surveys, out of 280 returned the score for knowledge about SARS was 72.0+/-13.7, 50.6% responded positively about joining a SARS team, and 23.1% were opposed to the designation for quarantining. There was no relationship between the degree of knowledge of SARS and the attitudes to it. Most employees wanted to know how to manage SARS patients and how to prevent SARS. CONCLUSION: The attitudes to SARS were not affected by the level of knowledge of SARS. We suggest that national policies about SARS and other infectious diseases should be promulgated using the mass media and internet to provide information on rapidly spreading infectious agents, especially about the proper protocol for treating suspected cases and the appropriate steps to prevent or reduce the risk.
Communicable Diseases ; Gangwon-do ; Humans ; Intention ; Internet ; Korea ; Mass Media ; Quarantine ; Surveys and Questionnaires ; Severe Acute Respiratory Syndrome

Backgrounds: Evaluating quality of life (QoL) in people with dementia has become increasingly valued, especially in assessing the effectiveness of interventions or making treatment decisions. However, limited information exists regarding dementia patients' QoL in Korea. The aim of our investigation was to determine if the severity of dementia could affect the QoL of patients with dementia and the relationship between QoL score and the scores of other cognitive domains, especially, the attention. METHODS: Two hundred and sixty eight subjects with varying degree of cognitive dysfunction underwent assessment of Korean-Mini Mental Status Examination (K-MMSE), digit span, trail making test (TMT), Korean-Instrumental Activity Daily Living (K-IADL), Geriatric Depression Scale (GDS), Clinical Dementia Rating Scale (CDR), attention and their QoL using standardized neuropsychological tests and questionnaires. We administered the QoL in Alzheimer's disease (QoL-AD) scale and attention questionnaire to the subjects. RESULTS: QoL-AD score had a positive correlation with K-MMSE score (r=0.38, p<0.0001) while it showed a negative correlation with GDS (r=-0.62 p<0.0001). QoL-AD score also showed a significant correlation with attention status of the patients with dementia (r=0.48, p<0.0001). QoL-AD score for patient appeared to be affected by educational factors. CONCLUSIONS: QoL-AD may be used as an effective tool to assess QoL as well as cognitive functions of patients with varying degree of dementia.
Alzheimer Disease ; Dementia ; Depression ; Humans ; Korea ; Neuropsychological Tests ; Quality of Life ; Surveys and Questionnaires ; Trail Making Test

OBJECTIVE: We tried to investigate the activity of iron-uptake system (IUS) of Stap hylococcus aureus according to the isolation sites and thus the relatedness between IUS and virulence. METHODS: Seventy clinical isolates were classified into the isolates from patients (56), from doctors and nurses (7) and from hospital environments (7). The isolates from patients (56) were sub-classified into the isolates from hospitalized patients (40; HP) and from outpatients (16; OP). Siderophore activity was measured CAS agar diffusion assay and transferrin-binding protein (tbp) was detected by receptor-ligand binding assay. RESULTS: There was no difference of siderophore production among the isolates from patients, doctors and nurses, and hospital environments (P>0.05). However, the isolates from patients expressed more tbp than the isolates from doctors and nurses and hospital environments (P<0.05). The isolates from OP produced more siderophore and expressed more tbp than the isolates from HP (P<0.05). CONCLUSION: These results suggested that Staphylococcus aureus with more active IUS is more virulent and more easily causes infection even in patients with relatively good general condition.
Agar ; Diffusion ; Humans ; Outpatients ; Staphylococcus aureus ; Virulence

BACKGROUND: We could establish a streptonigrin-resistant strain called SR-1 strain from Staphylococcus aureus ATCC 6538 as a parental strain and characterize SR-1 strain as defective in the iron-uptake mechanisms including production of siderophores and expression of transferrin-binding protein on the cell wall. We performed this study to elucidate effect of the iron-uptake mechanisms on the growth in human body fluids. METHODS: Growth kinetics of SR-1 strain were compared with those of the parental strain and the increase of unsaturated iron-binding capacity (UIBC) was measured. Siderophore production and expression of transferrin-binding protein were detected by CAS diffusion assay and ligand-blot method probed with human transferrin conjugated horseradish peroxidase, respectively, as the strains were cultivated in normal pooled sera, ascitic fluid and pleural effusion. RESULTS: Siderophores activity in the body fluids could not be detected by the CAS diffusion assay. The parental strain expressed the transferrin-binding protein on the cell wall during the growth in ascites and pleural effusion except the sera whereas SR-1 strain did not. Growth kinetics showed that SR-1 strain grew sluggish compared to the parental strain. The peak of increase of UIBC of the parental strain was observed at the mid-exponential growth phase and the increase of UIBC of SR-1 strain was either lower than that of the parental strain or not changed. CONCLUSION: The iron-uptake mechanisms of S. aureus, especially expression of transferrin-binding protein, play a significant role in growing in the body fluids.
Ascites ; Ascitic Fluid ; Body Fluids ; Cell Wall ; Diffusion ; Horseradish Peroxidase ; Human Body* ; Humans* ; Iron* ; Kinetics ; Parents ; Pleural Effusion ; Siderophores ; Staphylococcus aureus* ; Staphylococcus* ; Streptonigrin ; Transferrin

No abstract available.
Staphylococcus aureus* ; Staphylococcus*

Severe bronchospasm at the termination of the cardiopulmonary bypass period is an unusual but dangerous complication of open-heart surgery. We report a case of severe unilateral bronchospasm detected at the end of the bypass period on the basis of high airway pressures with remarkable difficulties to deflate the right lung and it was relieved with bronchodilator therapy by intrapulmonary percussive ventilation. Fiberoptic bronchoscopic examination revealed unobstructed, free tracheobnncheal airway and capnographic finding was obstructive pattern. As in the previously published cases, the exact cause of bronchospasm remains unknown in our patient as well, but the possible causes of the bronchospasm are described.
Bronchial Spasm* ; Cardiopulmonary Bypass* ; Humans ; Lung ; Ventilation

PURPOSE: Robotic surgery (RS) overcomes the limitations of previous conventional laparoscopic surgery (CLS). Although meta-analyses have been published recently, our study evaluated the latest comparative surgical, urologic, and sexual results for rectal cancer and compares RS with CLS in patients with rectal cancer only. METHODS: We searched three foreign databases (Ovid-MEDLINE, Ovid-Embase, and Cochrane Library) and five Korean databases (KoreaMed, KMbase, KISS, RISS, and KisTi) during July 2013. The Cochrane Risk of Bias and the Methodological Index for Non-Randomized were utilized to evaluate quality of study. Dichotomous variables were pooled using the risk ratio (RR), and continuous variables were pooled using the mean difference (MD). All meta-analyses were conducted with Review Manager, V. 5.3. RESULTS: Seventeen studies involving 2,224 patients were included. RS was associated with a lower rate of intraoperative conversion than that of CLS (RR, 0.28; 95% confidence interval [CI], 0.15-0.54). Time to first flatus was short (MD, -0.13; 95% CI, -0.25 to -0.01). Operating time was longer for RS than that for CLS (MD, 49.97; 95% CI, 20.43-79.52, I2 = 97%). International Prostate Symptom Score scores at 3 months better RS than CLS (MD, -2.90; 95% CI, -5.31 to -0.48, I2 = 0%). International Index of Erectile Function scores showed better improvement at 3 months (MD, -2.82; 95% CI, -4.78 to -0.87, I2 = 37%) and 6 months (MD, -2.15; 95% CI, -4.08 to -0.22, I2 = 0%). CONCLUSION: RS appears to be an effective alternative to CLS with a lower conversion rate to open surgery, a shorter time to first flatus and better recovery in voiding and sexual function. RS could enhance postoperative recovery in patients with rectal cancer.
Bias (Epidemiology) ; Flatulence ; Humans ; Laparoscopy* ; Odds Ratio ; Prostate ; Rectal Neoplasms*

POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, monoclonal M protein, and skin lesion) is a rare multisystemic disease of unknown cause with varying clinical manifestations. Amyloidosis-associated POEMS Syndrome is also rare condition. We experienced a 63-year-old female who had been suffered from edema and tingling sensation of low extremities. She also had a marked demyelination, axonal degeneration and regeneration of the nerve, hypoaldosteronism, hyperprolactinemia, decreased sexual hormone, monoclonal gammopathy (IgG lambda type), skin change and ascites. The renal biopsy revealed homogenous mesangial widening with a few cell nuclei at the glomerular capillary, and it showed positive apple-green birefringence in Congo-red stain. It's the first report that shows the deposition of amyloid in patients with POEMS syndrome in Korea. Edema and M-spike were improved by use of prednisolone, melphalan, fludrocortisone and colchicine.
Amyloid ; Amyloidosis* ; Ascites ; Axons ; Biopsy ; Birefringence ; Capillaries ; Cell Nucleus ; Colchicine ; Demyelinating Diseases ; Edema ; Extremities ; Female ; Fludrocortisone ; Humans ; Hyperprolactinemia ; Hypoaldosteronism ; Korea ; Melphalan ; Middle Aged ; Paraproteinemias ; POEMS Syndrome* ; Prednisolone ; Regeneration ; Sensation ; Skin