No abstract available.
Adult* ; Humans ; Lung* ; Pneumocytes* ; Pneumonectomy* ; Rabbits*

BACKGROUND: Negative U wave is frequent maker of systemic hypertension, aortic or mitral regurgitation and myocardial ischemia. This study was undertaken to determine the diagnostic significance of exercise-induced negative U wave in coronary artery stenosis. METHOD: 72 patients(46 men and 26 women ; 24~66 years of age) with chest pain were analysed with exercised-induced negative U wave and coronary angiographic finding. RESULT: Exercise-induced negative U wave was seen in 14 patients(19%). Among 14 patients with exercise-induced negative U wave, the predictive value of significant coronary artery stenosis(> or =75% stenosis of major coronary artery) was 71%, Exercise-induced negative U wave is more prevalent in patients with significant coronary artery stenosis(p<0.05). CONCLUSION: Exercise-induced negative U wave is a good marker of significant coronary artery stenosis.
Chest Pain ; Constriction, Pathologic ; Coronary Angiography ; Coronary Stenosis* ; Coronary Vessels* ; Female ; Humans ; Hypertension ; Male ; Mitral Valve Insufficiency ; Myocardial Ischemia

Since February 1978 until August 1982, we have made a diagnosis of 92 cases of spontaneous intracerebral hematomas by CT scan. These cases revealed the following results : 1) Hypertension was the most common cause of spontaneous intracerebral hematomas(63.0%), and followed by arteriovenous malformation(18.5%), aneurysm(9.8%), tumor bleeding(5.4%), blood dyscrasias(2.2%), and cerebral rete mirabile(1.1%). 2) Putaminal hemorrhages were found in 48.3%, subcortical hemorrhages in 29.3%, intracerebellar hemorrhages in 12.1%, thalamic hemorrhages in 10.3%. 3) The operative mortality in 56 cases was 36.8% and other case's mortality was 50%.
Aneurysm ; Arteriovenous Malformations ; Diagnosis ; Hematoma* ; Hemorrhage ; Hypertension ; Mortality ; Tomography, X-Ray Computed

Cerebellar astrocytomas have some characteristics such as benign histologic features, frequent cyst formation, tumors of early life and good postoperative prognosis. Cerebellar astrocytomas may arise from any part of cerebellum and tumors originated from vermis usually grew symmetrically in the vermis or invade the hemisphere. We recently experienced a case of cerebellar astrocytoma which entirely filled the 4th ventricle without evidence of tumor growth in the vermis or hemisphere. We report this case with its autopsy findings.
Astrocytoma* ; Autopsy ; Cerebellum ; Prognosis

Computerized tomography as a diagnostic procedure is characterized by its high sensitivity but limited specificity. This lack of specificity may result in erroneous diagnosis because many different pathological processes can have similar enhancement patterns. We prosent a patient with a nonspecific inflammatory lesion which was erroneously diagnosed as having an rapidly growing malignant glioma on sequential computerized tomography. We confirmed this lesion as a nonspecific inflammatory process by brain biopsy and the extensive lesion was disappeared after steroid therapy.
Biopsy ; Brain ; Diagnosis ; Glioma* ; Humans ; Pathologic Processes ; Sensitivity and Specificity

BACKGROUND/AIMS: We conducted a prospective, randomized, double-blinded, placebo-controlled trial to investigate the effect of hyoscine-N-butyl bromide during colonoscopy. METHODS: A total of 133 patients undergoing colonoscopy were randomized to receive either 20 mg of hyoscine-N-butyl bromide (n=70) or normal saline solution (n=63) via intramuscular injection as premedication. RESULTS: The mean cecal intubation time and withdrawal time in the hyoscine-N-butyl bromide group were significantly shorter than those of the control group (5.26+/-2.78 min vs. 6.74+/-4.89 min; p=0.032, 5.42+/-1.54 min vs. 6.18+/-2.54 min; p=0.038, each). The spasm grade in the hyoscine-N-butyl bromide group was significantly lower than that of the control group (p<0.001). No significant differences were found in the polyp detection rate (15.7% vs. 28.6%; p=0.073) and adenoma detection rate (10.0% vs. 15.9%; p=0.311). Difficulty of colonoscopy for the endoscopists and nurses (p=0.853; p=0.732), the patient's comfort (p=0.891) and the patient's willingness to repeat colonoscopy (85.7% vs. 82.5%; p=0.932) were also similar in both groups. CONCLUSIONS: Premedication with intramuscularly administered hyoscine-N-butyl bromide do not demonstrate any additional benefits except reducing the colonoscopy insertion time.
Adenoma ; Colonoscopy ; Humans ; Injections, Intramuscular ; Intubation ; Parasympatholytics ; Polyps ; Premedication ; Prospective Studies ; Scopolamine Hydrobromide ; Sodium Chloride ; Spasm

BACKGROUND AND OBJECTIVES: The speckle tracking method using 2-dimensional (2D) echocardiography is not affected by the tethering of neighboring segments and angulation. Global circumferential strain (GCS) of the left ventricle (LV) has been suggested as a systolic index and correlated with LV contractility. The purpose of this study was to investigate whether acute changes in preload affect global circumferential strain and to evaluate the usefulness of GCS by the speckle tracking method. SUBJECTS AND METHODS: 2D echocardiography was performed in 69 patients with end-stage renal disease before and after hemodialysis to measure the LV end-diastolic volume and LV ejection fraction. 2D images were acquired from the short-axis view of the mid-LV for the evaluation of GCS. RESULTS: Mean LV end-diastolic volume significantly decreased from 91.2+/-33.3 mL to 72.3+/-32.0 mL (p+/-0.05), and LV ejection fraction decreased from 63.6+/-13.1% to 60.0+/-11.2% (p=0.006) after hemodialysis. However, mean GCS showed no significant change after hemodialysis (17.2+/-5.3% vs. 16.6+/-4.7%, p=0.13). GCS was found to be well correlated with LV ejection fraction (r=0.54, p<0.05) and peak systolic mitral annular velocity (r=0.46, p=0.000), but not with LV preload (r=0.06, p=0.622). CONCLUSION: GCS using the speckle tracking method is a useful index for the evaluation of LV systolic function because it is not affected by acute preload change and is correlated with LV ejection fraction and peak systolic mitral annular velocity.
Echocardiography ; Heart Ventricles ; Humans ; Kidney Failure, Chronic ; Renal Dialysis ; Sprains and Strains ; Stroke Volume ; Track and Field ; Ventricular Function, Left

No abstract available.
Echocardiography ; Heart

The guidelines for chronic obstructive pulmonary disease (COPD) treatment are important for the management of the disease. However, studies regarding the treatment adherence to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines have been scarce in Korea. Therefore, to examine the adherence to the GOLD guidelines, we examined the patterns of prescribed medication in COPD patients from 2011 to 2018. Patients were classified as having been appropriately and inappropriately treated (overtreatment or undertreatment) for the GOLD group. Appropriate medical therapy was defined as using the first choice or alternative choice drug recommended in the GOLD guidelines. Inappropriate therapy was classified as overtreatment or undertreatment in accordance with the categorization in the GOLD guidelines. According to treatment of 2011 GOLD guidelines, there was inappropriate treatment in 52.3% in group A, 47.3% in group B, 56.3% in group C, and 17.8% in group D. According to treatment of 2017 GOLD guidelines, there was inappropriate treatment in 66.7% in group A, 45.3% in group B, 14.3% in group C, and 24.0% in group D. The common type of inappropriate COPD treatment is overtreatment, with inhaled corticosteroid (ICS) containing regimens. In conclusions, adherence to the GOLD guideline by the pulmonologist in clinical practice is still low in Korea. Therefore, we need better strategies to both optimize the use of the guidelines and adhere to the guidelines as well.
Humans ; Korea* ; Lung Diseases ; Medical Overuse ; Pulmonary Disease, Chronic Obstructive*

BACKGROUND: Ota's nevus, characterized by the presence of melanocytes in the dermis, has been familiar among dermatologists, but the etiology, the pathophysiology, the clinical and histological classification are not entirely clear. To understand and elucidate them, more clinical studies and researches are necessary. OBJECT: The aim of this study was to document the clinical and histopathological features of Ota's nevus. METHODS: We examined 299 patients with Ota's nevus who visited the dermatology clinic in Korea from February 1993 to August 2003. Among them, 188 patients were biopsied. All the specimens were stained with hematoxylin and eosin. We examined the age & sex distribution, age of onset, seasonal variation, associated skin diseases, aggravating factors and color. We clinically classified Ota's nevus into 4 types according to Tanino's classification and histologically into 5 types based on the pattern of pigmentation. RESULTS: 1. The ratio of male and female was 1: 3. 2. The peak age of onset was at birth (28.4%) and puberty (24.8%). 3. Seasonal variation was observed with distinct aggravation in the summer (60%). 4. The associated diseases were 9 cases of persistent mongolian spot, 6 cases of nevus flameus, 4 cases of blue nevus, 3 cases of vitiligo, 3 cases of nevus of Ito, 2 cases of atopic dermatitis, 2 cases of psoriasis, 2 cases of cafe au late macules and 2 cases of contact dermatitis. 5. The aggravating factors were sunlight (35.8%), emotional stress (21.0%), menstruation (12.6%), cold exposure (9.5%), pregnancy (9.5%), fatigue (9.5%) and chemical agents (2.1%). 6. The color of lesions were blue black (36.8%), brown (34.8%), dark brown (16.1%) and slate (11.0%). 7. All cases were classified according to Tanino's METHODS: type Ia (23.1%), type Ib (20.1%), type II (26.7%), type III (9.4%), type IV (20.7%). 8. The histological subtypes of Ota's nevus were classified as: the superficial type (35.6%); the middermis type (5.9%), the superficial-middermis type (18.6%); the mid-lower dermis type (2.7%); the diffuse type was composed of the superficial dominant type (19.7%), the middermis dominant type (4.8%), the dispersed (true diffuse) type (12.2%) and the deep dominant type (0.5%). 9. In the relation between histological types and the color of the lesion: the superficial type had 31 cases of brown color, 15 cases of blue black color, 11 cases of dark brown color and 9 cases of slate color; the middermis type had 6 cases of blue black color and 2 cases of dark brown color, query number of cases of slate color; the superficial-middermis type had 12 cases of blue black color, 10 cases of dark brown color, 7 cases of brown color and 6 cases of slate color: the mid-lower dermis type had 3 cases of blue black color; for the diffuse type, the superficial dominant type had 13 cases of brown color, query number of cases of blue black color and 7 cases of dark brown color; the mid-dermis dominant type had 4 cases of brown color, query number of cases of dark brown color, the dispersed type had 14 cases of blue black color and 5 cases of brown color; the deep dominant type had 1 case of blue black color. CONCLUSION: The histological reclassification of Ota's nevus may be very useful in making a therapeutic prognosis of the disease.
Adolescent ; Age of Onset ; Classification ; Dermatitis, Atopic ; Dermatitis, Contact ; Dermatology ; Dermis ; Eosine Yellowish-(YS) ; Fatigue ; Female ; Hematoxylin ; Humans ; Korea ; Male ; Melanocytes ; Menstruation ; Mongolian Spot ; Nevus ; Nevus of Ota* ; Nevus, Blue ; Parturition ; Pigmentation ; Pregnancy ; Prognosis ; Psoriasis ; Puberty ; Seasons ; Sex Distribution ; Skin Diseases ; Stress, Psychological ; Sunlight ; Vitiligo