No abstract available.
Actinomycosis* ; Hemoptysis*

The majority of ptients with ischemic heart disease such as angina pectoris and myocardial infarction have coronary atherosclerosis as a underlying cause. However, in unusual conditions such as variant angina, aortic valvular heart disease, hypertrophic cardiomyopathy, vasculitis, hypercoagulable states, coronary atherosclerosis is not the cause. Polycythemia vesa is a myeloproliferative disease characterized by infrequent thromboembolic complications such as ischemic heart disease. We report a case of polycythemia vera presenting with angina pectoris without coronary artery stenosis with the review of the literature.
Angina Pectoris* ; Cardiomyopathy, Hypertrophic ; Coronary Artery Disease ; Coronary Stenosis* ; Coronary Vessels* ; Heart Valve Diseases ; Myocardial Infarction ; Myocardial Ischemia ; Polycythemia Vera* ; Polycythemia* ; Vasculitis

OBJECTIVE: The positive rates of hepatitis B virus (HBV) markers differ according to age, sex, race, locality, sexual behavior, socioeconomic conditions, immunologic and genetic factors. It is a well-known fact that Korea is one of the endemic areas of HBV infection in the world. Past many reports have presented that the positive rates of HBsAg and anti-HBs in Korea were about 6~14% and 30~62%, respectively. However there were a few epidemiological surveys of rural communities on the positive rates of HBV markers. The present study undertook to determine the positive rates of HBsAg and anti-HBs in Hwasun county, a rural area of Korea. METHODS: We performed Population-based cross- sectional study by random cluster sampling of registered residents in Hwasun county. Out of the 2,920 subjects (4.1%) scheduled for the survey, 1,913 residents underwent the actual examination. We tested HBsAg and anti- HBs by reversed passive hemagglutination (RPHA) and passive hemagglutination (PHA), respectively. RESULTS: The positive rates of HBsAg and anti-HBs in all subjects were 5.6% and 20.8%, respectively, and those were 5.4% and 20.4% in 168 pregnant women, respectively. The positive rate of HBsAg was significantly higher in male (8.2%) than in female (4.0%) (p< 0.01). The positive rate of anti-HBs was 21.4% in female, but it was not significanly higher than in male (19.6%). There were no significant differences according to age groups in the positive rates of HBsAg and anti-HBs. CONCLUSION: There are no significant changes in the positive rates of HBsAg and anti-HBs between the present study for Hwasun county and past many reports in Korea. Although the rate of hepatitis B vaccination increased significantly, it was not effective because that the vaccinated total numbers in the rural area of Korea were probably small. So it is very important to undertake a nationwide program of hepatitis B immunization and to educate the residents in rural areas of Korea.
Continental Population Groups ; Female ; Hemagglutination ; Hepatitis B ; Hepatitis B Surface Antigens* ; Hepatitis B virus ; Humans ; Immunization ; Korea* ; Male ; Pregnant Women ; Rural Population ; Sexual Behavior ; Vaccination

Simple renal cyst is the most common space- occupying lesion of kidney in adults. However, there were a few systematic Korean reports for the prevalence of simple renal cysts. Our purpose was to estimate the prevalence of simple renal cysts using ultrasonography, and to determine the relations to age and hypertension. The subjects were 504 volunteers (aged over 29 years) of the persons who were enrolled a health check-up program of Naju Hospital, Naju, Korea. Number of male in 504 persons was 334 (66.3%) and female 170 (33.7%). Mean age was 55 years (range; 30-86). The results were as follows: 1) One or more renal cysts were found in 50 individuals of 504 persons aged over 29 years (9.9%). In 331 persons aged over 49 years, the prevalence of simple renal cysts was 12.1%. The prevalence was significantly increased with age (P<0.001), but the difference between male (9.6%) and female (10.6%) was insignificant. 2) Mean value of cyst diameter was 23mm (5-69 mm) and was not correlated with age. However, the cyst diameter was significantly higher in female than in male, 32.4mm vs 18.0mm (P<0.001). Total number of cysts per person tended to increase with age (P<0.001). 3) The correlation between prevalence of simple renal cysts and blood pressure was statistically insignificant. However, the prevalence of hypertension in persons with cysts was higher than in persons with no cyst (27.9% vs 15.3%, P<0.05). Cyst diameter was not correlated with blood pressure. 4)Urinalysis in persons with cysts, showed microscopic hematuria in 47.4% and proteinuria in 26.3 %, however, grade of microscopic hematuria and proteinuria were not correlated with cyst diameter. The concentrations of blood urea nitrogen, serum creatinine, hemoglobin and hematocrit were not affected by presence or absence of simple renal cysts. By comparison with the recent foreign reports, the prevalence of simple renal cysts in Korean was similar to those in foreigners. Our study ascertained that simple renal cysts are age-dependent and total number of cysts per person also increases with age. In most of persons with simple renal cysts, the renal function is not affected and the related symptoms are trivial. However, we suggested that simple renal cysts may cause hypertension. To elucidate the correlation between simple renal cyst and hypertension, further studies are needed.
Adult ; Blood Pressure ; Blood Urea Nitrogen ; Creatinine ; Emigrants and Immigrants ; Female ; Hematocrit ; Hematuria ; Humans ; Hypertension* ; Jeollanam-do ; Kidney ; Korea ; Male ; Prevalence* ; Proteinuria ; Ultrasonography* ; Volunteers

In this experiment, pregnant Sprague-Dawley rats were treated with 100mg/kg of alltrans retinoic acid at 10th day of gestation. Pregnant rats were sacrificed at gestation day 14, 15, 16 and 18. Fetuses were delivered, and palatal processes were dissected. The specimens were prepared with fibronectin immunohistochemical stain, and mesenchymal changes were observed with electron microscope. The results were as follows. 1. In the findings fo fibronectin immunohistochemial stain, a part of the mesenchyme of the palatine process of the control group showed weak positive reaction at 14th gestation day, and the reactivity increased progressively by each day. In retinoic acid treated group, the positive reaction was trace at 14th day of gestation, and the reactivity increased progressively, but it was weaker than that of the control group. 2. Examination under transmission electron microscopy revealed well-developed rough endoplasmic reticulum, Goigi apparatus, mitochondrias which were found at the palatine process of the control group. In the retinoic acid treated group, at 16th and 18th day of gestation, the mesenchymal cells of the elevated palatine process had fragmented, sacculated rough endoplasmic reticulums, their mitochondrias were swollen and dissolved, In all cases with retinoic acid treated group, mitotic cells at various stages were more frequently found than in control group. In conclusion, the retinoic acid induces alterations of the intracytoplasmic organells. This finding suggests that retinoic acid is ditectly cytotoxic to mesenchymal cells. Positive fibronectin reaction was demonstrated before palatal elevation at th 15th day of gestation. Therefore, it could be postulated that mesenchymal cells synthesize and release the fibronectin. In the retinoic acid treated group, fibronectin showed positive reaction before and after palatal elevation, and it suggests that fibronectin would be involved in palatal elevation.
Animals ; Endoplasmic Reticulum, Rough ; Fetus ; Fibronectins ; Mesoderm* ; Microscopy, Electron, Transmission ; Mitochondria ; Pregnancy ; Rats* ; Rats, Sprague-Dawley ; Tretinoin*

BACKGROUND: Cervical tuberculous lymphadenitis(CTL) is one of the most common extra-pulmonary tuberculosis. Recently overall incidence of pulmonary tuberculosis has decreased, but the incidence of tuberculous lymphadenitis has not decreased. Its duration of treatment is still controversial and the pathogenesis, prognosis and relationship with other site tuberculous are poorly published. So we did a retrograde study of 120 cases of confirmed CTL about its clinical manifestations. METHODS: All patients were applied fine needle aspiration(FNA) of palpable enlarged cervical lymph nodes and 114 patients were examined for AFB smear and 34 patients for TB culture with aspirated fluid. 57 patients were examined Mantoux test(5TU with PPD-S). With above methods, a total of 120 patients was diagnosed as having CTL RESULTS: 1) CTL is most prevalent in young women between the age of 20 30 years and the incidence of CTL in female is 2.5 times higher than that of male. It is located most commonly in the posterior cervical area. The most common presenting symptom is painless palpable enlarged cervical lymph nodes. 2) With FNA of enlarged cervical lymph nodes, the percentage of histopathological positivity is 82.3%. The percentage of AFB smear positivity is 38.6%, and that of TB culture positivity is 17.6% (p<0.001). 3) Pulmonary tuberculosis is noted in 79 cases(65.8%). And 42 cases(53.5%) of them had minimal pulmonary tuberculosis. In 14 cases(11.7%),other extrapulmonary tuberculosis coexsisted and pleural tuberculosis was most common in the order. 4) CTL was treated with anti-tuberculous medication(first line drug) and median treatment duration was 18.5months. During treatment, the size of involved lymph nodes decreased gradually in 62 cases(75.8%), newly developed lymph nodes were found in 25 cases(30.4%),fluctuation formation in 22 cases(26.8%) and fistula formation in 14 cases(17.0%). CONCLUISON: CTL is prevalent in women between the age of 20 ~ 40 years and it involves posterior cervical area most commonly. CTL is treated with long-term anti-tuberculous chemotherapy. We think it is one manifestation of systemic disease and frequently coexisting with pulmonary tuberculosis. Despite anti-tuberculous chemotherapy, the size of involved lymph nodes was increased, new lymph nodes were developed or fluctuation and fistula formed in involved lymph nodes. After sufficient medication, when the patient felt pressure discomfort from enlarged lymph node or fistula was formed, we recommended total excision of involved lymph nodes.
Drug Therapy ; Female ; Fistula ; Humans ; Incidence ; Lymph Nodes ; Male ; Needles ; Prognosis ; Tuberculosis ; Tuberculosis, Lymph Node* ; Tuberculosis, Pleural ; Tuberculosis, Pulmonary

OBJECTIVE: The cordocentesis is regarded as an useful procedure for the prenatal evaluation of fetal disease, but it's complications are fetal loss, umbilical cord bleeding, umbilical cord hematoma, fetal bradycardia, fetomaternal hemorrhage, abruptio placentae, and chorioamnionitis due to it's invasiveness. The fetal bradycardia following cordocentesis is transient and self-limited in most cases, and the prevalence rate of fetal bradycardia following cordocentesis was reported to be between 1.5 and 13 per cent. The purpose of this study was to evaluate the association of fetal heart rate pattern following cordocentesis with adverse pregnancy outcome. METHODS: We investigated retrospectively the fetal heart rate following cordocentesis, the Apgar score of neonate, the birth weight of neonate, gestational age at delivery, preterm delivery, intrauterine growth retardation, stillbirth, and chromosome analysis in 64 codocenteses between 1 February 2000 and 28 February 2001. Normal fetal heart rate was defined as 100 up to 170 bpm, fetal bradycardia as less than 100 bpm lasting one more minute, and fetal tachycardia as more than 170 bpm lasting one more minute. RESULTS: 1. Fetal heart rate pattern following the cordocentesis was normal in 53 cases (82.8%), bradycardia in 6 cases (9.4%) and tachycardia in 5 cases (7.8%). 2. The pregnancy outcome was well-being fetus at birth in 51 cases, terminated pregnancy in 5 cases, intrauterine growth restricted fetus in 5 cases, preterm birth in 1 case and intrauterine death in 2 cases. 3. Mean Apgar-1minute/-5minute scores in neonates were 8.4 +/- 0.2/9.3 +/- 0.2 in the normal fetal heart rate group, 6.8 +/- 1.7/7.6 +/- 1.9 in fetal bradycardia group and 8.4 +/- 0.2/9.4 +/- 0.2 in fetal tachycardia group, that showed no statistically significant difference between groups. 4. The gestational weeks at birth/birth weight were 38.9 +/- 0.4 weeks/3193 +/- 90 g in normal fetal heart rate group, 36.8 +/- 3.2 weeks/2733 +/- 340 g in bradycardia group and 40.0 +/- 0.2/3465 +/- 21 g in tachycardia group, that showed no statistically significant difference between groups. 5. The number of puncture at the same time of cordocentesis was one in 45 cases, two in 15 cases and three in 4 cases. 6. There was no difference in fetal heart rate pattern following cordocentesis between 60 cases of normal and 4 cases of abnormal cardiovascular findings sonographycally. 7. The karyotyping was normal in 60 cases and abnormal in 4 cases, each of which was 46,XY,inv(9),46,X,i(Xq)/45,X,47,XY,+mar, and 46,XX,t(7;15)(q10;q10) respectively. CONCLUSION: Fetal bradycardia or tachycardia following cordocentesis was not associated with adverse pregnancy outcomes.
Abruptio Placentae ; Apgar Score ; Birth Weight ; Bradycardia ; Chorioamnionitis ; Cordocentesis* ; Female ; Fetal Diseases ; Fetal Growth Retardation ; Fetal Heart* ; Fetomaternal Transfusion ; Fetus ; Gestational Age ; Heart Rate, Fetal* ; Hematoma ; Hemorrhage ; Humans ; Infant, Newborn ; Karyotyping ; Parturition ; Pregnancy ; Pregnancy Outcome* ; Pregnancy* ; Premature Birth ; Prevalence ; Punctures ; Retrospective Studies ; Stillbirth ; Tachycardia ; Umbilical Cord

Transverse myelitis (TM) extending from midbrain to the entire spinal cord accompanied by internuclear ophthalmoplegia is extremely rare but cause serious central nervous system complications in patients with systemic lupus erythematosus. We report a case of a 28-yr-old woman with TM extending from the midbrain to the conus medullaris longitudinally and internuclear ophthalmoplegia associated with systemic lupus erythematosus. Her neurological symptoms had an abrupt catastrophic onset and rapidly progressed to respiratory failure within 24 hr. Bilateral internuclear ophthalmoplegia was also followed by TM. Brain MR images showed definite brainstem lesions, which were deeply associated with internuclear ophthalmoplegia, and diffuse signal changes in the whole spinal cord, medulla, pons and midbrain. Clinical improvement of her ophthalmoplegia and of neurological dysfunction of the upper extremities was noted after prompt and aggressive treatment with intravenous pulsed methylprednisolone and cyclophosphamide. However, the neurological dysfunction of the lower limbs and bladder and colon paralysis were almost unchanged until six months passed.
Adult ; Cyclophosphamide/therapeutic use ; Female ; Humans ; Lupus Erythematosus, Systemic/*complications ; Magnetic Resonance Imaging ; Myelitis, Transverse/diagnosis/drug therapy/*etiology ; Ocular Motility Disorders/diagnosis/drug therapy/*etiology ; Prednisolone/therapeutic use

An aortic aneurysm is described as a permanent localized dilatation of the aorta having a diameter at least 1.5 times that of the expected norrnal diameter of that given aortic segment. Thoracic aortic aneurysms are much less common than are aneurysms of the abdominal aorta. Thoracic aneurysms are classified by the portion of aorta involved, I.e., the ascending, arch, or descending thoracic aorta. We experienced a case of saccular arteriosclerotic aortic aneurysm associated with thrombus in aortic arch in a 78 year-old male who had history of hypertension. He was admitted to Kwangju Veterans Hospital complaining of drowsy mental state and swelling of left foreann. The chest X-ray, chest CT and echocardiogram showed saccular dilatation(maximal diarneter ; 7.67~7.86cm) associated with thrombus in aortic arch. He refused operation because of old age, so he was conservatively rnanaged including propranolol. We report this case of saccular arteriosclerotic aneurysm of aortic arch with a brief review of literature.
Aged ; Aneurysm ; Aorta ; Aorta, Abdominal ; Aorta, Thoracic* ; Aortic Aneurysm* ; Aortic Aneurysm, Thoracic ; Dilatation ; Gwangju ; Hospitals, Veterans ; Humans ; Hypertension ; Male ; Propranolol ; Thorax ; Thrombosis* ; Tomography, X-Ray Computed

PURPOSE: Airway management and ventilation at the pre-hospital stage are essential and very critical to patient welfare. In Korea, however, methods other than the use of a bag valve mask are hardly used at the pre-hospital stage by emergency medical technicians (EMTs). This study survey the current state of airway management and respiratory first aid at the pre-hospital stage. METHODS: A questionnaire survey of 356 EMTs was conducted by distributing questionnaires directly to first-class EMTs who participated in clinical training at emergency centers or by sending questionnaires and receiving answers by E-mail. The questionnaire solicited information concerning general characteristics of EMTs, monthly frequency of pre-hospital airway management of patients and the will of EMTs. Subjects were divided into two groups according to governmental subdivision or presence of training within 1-year. RESULTS: Concerning airway management and ventilation at the pre-hospital stage, the use of methods other than nasal prong and simple mask was very rare. As to the reasons, the respondents mentioned the shortage of manpower and lack of knowledge/experience. There was no significant difference in the ratio of pre-hospital airway management between urban and suburban/rural settings. Training within 1-year was not related to increased enforcement of airway management. CONCLUSION: In Korea, pre-hospital airway management is not well implemented by EMTs. Causes are deficiency of rescuer, less actual patient treatment experience and deficiency of knowledge/experience. Education and work experience can influence pre-hospital airway management. But, most pre-hospital airway management is unaffected by education and work experience.
Airway Management ; Surveys and Questionnaires ; Electronic Mail ; Emergencies ; Emergency Medical Technicians ; First Aid ; Humans ; Korea ; Masks ; Ventilation