The tuberculous panophthalmitis is, at present, extremely rare. The authors experienced a case of left tuberculous pailOphthalmitis which is, we imagine, secondary to the minimal active pulmonary tuberculosis of right upper lung of 17 year old girl. Here we briefly report a case of tuberculous panophthalmitis, referring the literature relating to the ocular trberculosis.
Adolescent ; Female ; Humans ; Lung ; Panophthalmitis* ; Tuberculosis, Pulmonary

Authors experienced two unusual cases of marginal blepharoconjunctivitis caused by infestion of pubic lice (Phthirus pubis) which were confirmed by slit lamp and light microscopic examination. The patients were forty-three year old Korean female who was infected from her husband and her six year old daughter who had used a same room with her father and mother. We could find pubic lice and ova on the cilia, pubic and axillar regions of female mother patient and cilia, eyeblow and head of her daughter and we could also find the pubic lice and ova on the pubic region of her husband. The prompt improvement of marginal blepharoconjunctivitis of both eyes of them were achieved by cutting of cilia and the use of topical antibiotics.
Anti-Bacterial Agents ; Cilia ; Fathers ; Female ; Head ; Humans ; Mothers ; Nuclear Family ; Ovum ; Phthiraptera* ; Spouses

The polyglandular autoimmune syndrome is constellation of multiple endocrine insufficiencies often associated with diseases of nonendocrine organs occurring in individual patients and their families. In 1980, Neufeld classified this syndrome into three major types. Type II is characterized by adrenocortical insufficiency, autoimmune thyroiditis, and insulin-dependent diabetes mellitus. We experienced a case characterized by adrenocortical insufficiency, autoimmune thyroiditis, and ovarian failure and report with the review of the literature. A 38-year-old woman visited our clinic because of progressing brown colored pigmentation of skin and mucosa which is developed a year ago. Nine years ago prior to visit, amenorrhea was developed after right oophrectomy. Three years ago, she revealed feature of hyperthyroidism such as palpitation, loss of body weight (8kg/1-2years), heat intolerance, and sweating, so received antithyroid therapy for 14 months. Brown colored pigmentation of skin and mucosa, especially scar and gingiva, has been progressively aggravated during last year. She had no past or family history of other endocrine disease. Diffuse pigmentation of skin, loss of axillary and pubic hair, and diffuse enlargement of both thyroid glands were shown on physical examination. Blood cell count, serum chemistry and blood sugar test were all within normal range. Basal hormone levels were T3-uptake 29.7% (30~40), T3 153 ng/dL (85~185), T4 7.5ug/dL (5.5~11.5), TSH 2.4 IU (0.34~3.5), anti-TG antibody <100 U/mL (0~100), anti-microsome antibody <50 U/mL (0~100), TBII (thyrotropin binding inhibiting immunoglobulin) 2.2% ( (-15)~15), ACTH 989 pg/mL (0~37), cortisol 0.1 ug/dL (5~25), renin 7.1ng/mL/hr (1~2.5), aldosterone 81.0pg/mL (50~194), LH 115.2 mIU/mL (0.6~16.8), FSH 122 mIU/mL (1.6~19.0), and estradiol <10.0pg/mL (30~120). In ACTH stimulation test, levels of basal cortisol, 30 minutes, and 60 minutes were <0.1, <0.1, and <0.1 g/dL respectively. And, in glucagon stimulation test, levels of basal C-peptide, 5 minutes, 10 minutes, and 15 minutes were 0.9, 5,1, 6.3, and 5.5 ng/dL respectively. Thyroid scan showed diffuse enlargement of bilateral thyroid glands and pelvic ultrasonogram showed atrophy of left ovary. We administered corticosteroid, estrogen, and progesterone which were deficient to the patient, and has followed up the clinical course of the patient.
Adrenocorticotropic Hormone ; Adult ; Aldosterone ; Amenorrhea ; Atrophy ; Blood Cell Count ; Blood Glucose ; Body Weight ; C-Peptide ; Chemistry ; Cicatrix ; Diabetes Mellitus, Type 1 ; Endocrine System Diseases ; Estradiol ; Estrogens ; Female ; Gingiva ; Glucagon ; Hair ; Hot Temperature ; Humans ; Hydrocortisone ; Hyperthyroidism ; Mucous Membrane ; Ovary ; Physical Examination ; Pigmentation ; Progesterone ; Reference Values ; Renin ; Skin ; Sweat ; Sweating ; Thyroid Gland ; Thyroiditis, Autoimmune ; Ultrasonography

BACKGROUND: This study reports findings from the ITC Korea Survey, which was conducted to evaluate the characteristics in Korean adult smokers as part of the ITC Project. METHODS: Adult male and female smokers were randomly selected using telephone survey from November to December 2005. The ITC Korea Survey contained a wide range of questions on smoking behavior and smoking history. The data reported are weighted on the basis of age and gender, and they are nationally representative of smokers in Korea. RESULTS: A total of 1,002 smokers among the selected 1,402 subjects (71.5%) were interviewed; 96.2% were males. Daily smokers comprised 94.5% of the sample. The mean of cigarettes per day was 17.9. The average minutes after waking before the first cigarette was smoked was lower (50.6 minutes) than it was in other countries of the ITC Project. Over 90% considered themselves addicted to cigarettes and 86.5% expressed regret over smoking. Smokers reported that the norms against smoking in Korea were very strong both personal norms (89.4%) and perceived norms in Korean society (86.3%). Among the smokers, 80.8% had tried to quit smoking, and 76.1% were planning to quit. Only 5.8% of the Korean smokers indicated that the warning labels made them a lot more likely to quit smoking. When the price of cigarettes increased by 500 won (25%) in December 2004, 34.3% reported trying to quit smoking. Only 17.7% supported a complete workplace ban and 15.8% supported a complete ban in restaurants. Although knowledge of the harms of smoking was high, nearly 80% of the Koreans wrongly believed that "nicotine causes most of the cancer in smokers." Finally, the great majority (85.2%) of smokers in Korea believed that "the government should do more to tackle the harm done by smoking" and 62.5% believed that "tobacco products should be more tightly regulated." CONCLUSION: The results from the baseline wave of the ITC Korea Survey have identified where tobacco control in Korea has been done. Future waves of the ITC Korea Survey will be able to evaluate the impact of important tobacco control policies that Korea will be required to implement over the next few years, as a party to the FCTC.
Adult ; Female ; Humans ; Korea ; Male ; Restaurants ; Smoke ; Smoking ; Telephone ; Tobacco ; Tobacco Products

This study was performed to find out nutritional factors associated with identification of chronic disease using neural network model. A dietary survey with 24-hour recall method was conducted together with a health survey including health qustionnaire, physical examination and glucose tolerance test to 2037 adults over 30 years of age in rural area of Korea. Subjects have been classified into groups with and without disease depending on each disease criteria(groups with desease include those who are newly diagnosed to have diabetes, hypertension, hyperlipidemia and obesity, respictively). Neural network method has been applied to predict disease using selected 3 nutrients out of 12 nutrient elements as input information and resulting outputs which designate either disease or without disease group. Backpropagation learning algorithm has been applied to train neural network structure assigning weight factors connecting each node. 20 subjects from both disease and without disease group have been collected to train neural network structure and remaining subjects were later used in order to test the validity of the trained structure. In order to quantify contrivution ratio of each nutrients for predictiong disease status, number of appearance frequency of each nutrients in the top 20 prediction rate has been compared. When a nutrient used 10 times for prediction, its appearance rate was calculated to be 50%. vitamin C, vitamin A and iron showed appearance rate of 70%, 40% and 30%, respectively for predicting diavetes. vitain C, Fat and beta-carotene showed appearance rate of 60%, 60% and 40% for predicting hypertension. For predicting hyperlipidemia, appearance rate of vitamin C, iron and energy was 65%, 55% and 30%, respectively. From the study, vitamin C was shown to be prominent in predicting chronic disease groups from subjects.
Adult ; Ascorbic Acid ; beta Carotene ; Chronic Disease ; Glucose Tolerance Test ; Health Surveys ; Humans ; Hyperlipidemias* ; Hypertension* ; Iron ; Korea ; Learning ; Neural Networks (Computer) ; Obesity* ; Physical Examination ; Vitamin A

A rapid response to corticosteroid treatment and a generally favourable outcome are characteristic features of BOOP (Bronchiolitis obliterans organizing pneumonia). However, with increasing experience of the clinical spectrum of this disease, it is now recognized that some patients are refractory to steroid, which is associated with a poor prognosis. Here, two cases of BOOP initially treated with predinisone and antibiotics without effects, but subsequently responded to secondary cyclosporine treatment, are reported.
Anti-Bacterial Agents ; Bronchiolitis Obliterans* ; Bronchiolitis* ; Cryptogenic Organizing Pneumonia* ; Cyclosporine* ; Humans ; Prognosis

BACKGROUND AND OBJECTIVES: The degree of diastolic dysfunction may explain the difference in clinical symptoms between patients with similar degrees of systolic dysfunction. Pseudonormal mitral filling pattern with increased left ventricular filling pressure is a transitional stage of diastolic dysfunction and is difficult to distinguish from normal. Preload is one of factors affecting the diastolic filling patterns and mitral flow patterns may be influenced by changes in preload in the absence of changes in the left ventricular pressure-volume curve. The changes in the mitral flow velocities caused by preload reduction may be useful in distinguishing patients with a pseudonormal pattern from those with normal. The aim of this study was to establish whether the effect of changes in pulmonary venous flow pattern by preload reduction may be useful in distinguishing pseudonormal pattern from normal. MATERIALS AND METHODS: This study included 40 patients (men 25, female 15, average age 51.0+/-11.2 years) underwent left side cardiac catheterization among patients with normal or pseudonormal patterns. All patients with pseudonormal group had increased LVEDPr (>15 mmHg). The Doppler mitral inflow & pulmonary venous flow parameters at baseline and during reduction of preload using Valsalva maneuver were recorded. RESULTS: 1) There were no difference in sex, diabetes mellitus, hypertension and lipid profiles between both groups. The left ventricular systolic function was better and mean age was younger in normal than pseudonormal group (p<0.05). The incidence of coronary artery disease was more frequent and LV mass was more increased in pseudonormal than normal group (p<0.05). 2) E and A velocities were significantly decreased but E/A ratio was still <0A65B> 1.0 during Valsalva maneuver in normal group (p<0.05). In pseudonormal group, E velocity was significantly decreased but A velocity was not significantly changed and the E/A ratio was <1.0 during Valsalva (p<0.05). Therefore the change revealed masked LV relaxation abnormality pattern. 3) S and D velocities of pulmonary venous flow were significantly decreased and S/D ratio was significantly increased in both groups (p<0.05). The % changes before and after Valsalva maneuver showed that S velocity was less decreased, D velocity was more decreased and S/D ratio was more significantly increased in pseudonormal than normal group (p<0.05). That revealed masked LV relaxation abnormality pattern. CONCLUSIONS: The Valsalva maneuver for preload reduction is a relatively simple, easily applicable, safe and reproducible method of acutely reducing venous return. The assessment of changes in pulmonary venous flow pattern by preload reduction may be helpful in distinguishing pseudonormal and normal diastolic function in addition to changes in mitral inflow pattern.
Cardiac Catheterization ; Cardiac Catheters ; Coronary Artery Disease ; Diabetes Mellitus ; Female ; Humans ; Hypertension ; Incidence ; Masks ; Relaxation ; Valsalva Maneuver

BACKGROUND: The hemodynamic effects of an episode of ventricular tachycardia (VT) may vary from mild decrease in blood pressure to sustained hypotension, collapse, and death. Little is known about the factors responsible for these diverse effects. Ventricular function, vasomotor tone, and tachycardia cycle length could be major determinants of variable hemodynamic responses to VT. The site of origin was found to be a factor affecting pulse pressure even in an isolated ventricular premature contraction. However, the role of origin site in hemodynamics of VT is not yet elucidated. The purposes of this study were to evaluate the effects of VT origin site and VT cycle length to their hemodynamic changes. And we also have assessed the role of cardiac autonomic receptor activation in hemodynamic recovery during and immediate after VT. METHODS: In 18 open chest dogs anesthetized with chloralose, bipolar ventricular pacing (VP) was performed using sutured epicardial electrodes at 3 different sites ; left ventricular apex (LVA), right ventricular outflow tract (RVOT), and right ventricular apex (RVA). At each site, VP was repeated for 60 seconds at 3 different rates; 1.75X, 2X, and 2.25X of baseline heart rate (BHR). Mean arterial pressure (MAP), mean left atrial pressure (MLAP) and mean pulmonary artery pressure (MPAP) were monitored during VP. deltaMAP was defined as the difference between the baseline MAP and lowest MAP during VP. deltaMLAP was defined as the difference between highest MLAP during VP and baseline MLAP. Cardiac vagal and beta-adrenoreceptor blockades were achieved by intravenous bolus administration of propranolol (1 mg/kg and then 1 mg/kg/hr) and atropine (0.5 mg/kg and then 0.5 mg/kg/hr). After cardiac autonomic blockade, VP was repeated at 2X of baseline heart rate for 60 seconds at each site. RESULTS: Baseline MAP, MLAP, and MPAP were 101+/-8.1 mmHg, 0.3+/-0.41 mmHg, and 10+/-2.4 mmHg, respectively. At the same pacing site of VP, MAP was decreased significantly with VP and deltaMAP was increased significantly as VP cycle length shortened (all P<0.001). At the same pacing cycle length of VP, deltaMAP was significantly greater at RVA or RVOT than LVA: LVA vs RVOT ; all P<0.001 at 3 different rates, LVA vs RVA ; P<0.05 (1.75X & 2X of BHR), P<0.001 (2.25X of BHR). But there was no significant difference in deltaMAP between RVA and RVOT. At the same pacing site of VP, MLAP and deltaMLAP were increased significantly as VP cycle length shortened (all P<0.01), but at the same cycle length of VP, there was no significant differences in deltaMLAP at 3 different VP sites. Ventricular pacing after autonomic blockade induced a greater increase in deltaMAP and deltaMLAP compared to controls (all P<0.01 at 3 pacing sites). And cardiac autonomic blockade also resulted in significant blunting of recovery of MAP during VP compared to controls. CONCLUSION: Above results showed that pacing cycle length plays a major role in determining the hemodynamic outcomes during ventricular pacing, and that the site of origin could be an independent factor of ventricular tachycardia hemodynamics. And also modulation of tone of the adrenergic nervous system is essentially required for the hemodynamic recovery during ventricular tachycardia.
Animals ; Arterial Pressure ; Atrial Pressure ; Atropine ; Blood Pressure ; Chloralose ; Dogs* ; Electrodes ; Heart Rate ; Hemodynamics* ; Hypotension ; Nervous System ; Propranolol ; Pulmonary Artery ; Tachycardia ; Tachycardia, Ventricular ; Thorax ; Ventricular Function

OBJECTIVES: Visualization of the left atrial appendage(LAA) by the transesophageal echocardiography(TEE) is excellent, but it is difficult to visualize the LAA by the modified parasternal short-axis view(MPSA) in transthoracic echocardiography(TTE). We studied to determine the usefulness of the apical horizontal view(AHV) abtained by the apical rotation method of the transducer for the detection of the LAA. METHODS: We studied the MPSA and AHV in 602 patients, The LAA was observed during diastole of the LAA. We obtained an apical horizontal view by 45 degree clockwise rotation of the transducer from the apical 2 chamber view and compared with the visualization of the LAA in AHV and MPSA. RESULTS: Among 602 patients, LAA could not be visualized in 88(14.6%) because of a poor echo-window. LAA was more clearly visualized in 222 patients by the AHV than the MPSA and 56 patients by the MPSA than the AHV. LAA was same degree visualization in patients by the AHV and MPSA. In male and female, more than 55 ages and less than 55 ages, visualization of inner margin of the LAA by the AHV was more clear than by the MPSA. CONCLUSION: The AHV was a useful, noninvasive and reproducible method for the visualization of the LAA.
Atrial Appendage* ; Diastole ; Female ; Humans ; Male ; Transducers*

BACKGROUND: Atrial fibrillation (Af) after open heart surgery may result in hypotension, heart failure, embolic complication and prolongation in length of hospital stay. Several studies have investigated the efficacy of pharmacological prophylaxis in reducing the incidence of Af after cardiac surgery. The pericardial sac represents a natural physical barrier and provides a drug receptacle to restrict drug delivery to the heart. The overall objective of this study was to determine whether the pericardial sac could function as a delivery chamber for antiarrhythmic drugs. We investigated whether quinidine delivered into the pericardial sac exerted an effect on atrial and ventricular refractoriness, impulse generation, and conduction. METHODS: All animals were anesthetized with alpha-chloralose. After a sternotomy, the pericardium was opened and cradled to produce a "container" of approximately 30 ml. Experimental animals received quinidine, 3.33 mg/ml, dissolved in Krebs-Henseleit solution instilled into their pericardial sacs for 30 minutes. Baseline and 5, 10 and 30 minutes postinstillation electrophysiologic studies were performed. Plasma quinidine levels were measured at each of the time intervals in three different sites i.e., right ventricle (RV), aortic root and femoral vein (FV). RESULTS: Baseline systolic (SAP) and diastolic aortic pressure (DAP) were 148+/-16.8 mmHg, and 111+/-23.9 mmHg, respectively. Both SAP and DAP were significantly decreased at 5, 10 and 30 minutes after instillation of quinidine solution into pericardial sac. In electrocardiographic parameters, the increase in sinus cycle length and corrected QT interval were significantly greater compared with baseline at each of the time intervals after instillation of quinidine solution into pericardial sac. All electrophysiologic parameters including 1:? AV conduction, effective refractory period (ERP) of RA and RV were significantly increased compared with baseline at three time points. Quinidine concentrations in RV and aorta were significantly higher than in FV at three time points. In RV and aorta, quinidine concentrations at 30 min were significantly lower than those at 5 and 10 min postinstillation periods. There were significant correlations between plasma quinidine levels and corrected QT interval or RAERP. CONCLUSION: Above results showed that quinidine instilled into the pericardial sac migrates transmurally and produces significant prolongation of effective refractory period and may appear to prevent various arrhythmias including atrial fibrillation after cardiac surgery.
Animals ; Anti-Arrhythmia Agents ; Aorta ; Arrhythmias, Cardiac ; Arterial Pressure ; Atrial Fibrillation ; Chloralose ; Electrocardiography ; Electrophysiology ; Femoral Vein ; Heart ; Heart Failure ; Heart Ventricles ; Hypotension ; Incidence ; Length of Stay ; Pericardium ; Plasma ; Quinidine* ; Sternotomy ; Thoracic Surgery