PURPOSE: To evaluate dysphagia objectively and quantitatively, and ta clarify the effect of neck position and viscosity changes in patients with aspiration and laryngeal penetration. MATERIALS AND METHODS: We studied 35 patients with dysphagia and 21 normal controls using videofluoroscopy and scintigraphy. Videofluoroscopy was performed with barium with three different viscosity, and scintigraphy was done, with water, yogurt, and steamed egg mixed with Tc-99m tin colloid. 1f aspiration was found during videofluoroscopic examination, patients neck position was changed and study repeated. Videofluoroscopy was analyzed qualitatively. We calculated 7 quantitative parameters from scintigraphy. According to the videofluoroscopic findings, we divided patients into 3 subgroups; aspiration, laryngeal penetration, and no-aspiration group. RESULTS: The result of videofluoroscopy revealed that the most cornmon finding was the delay in triggering pharyngeal swallow. Pharyrigeal transit time (PTT) and pharyngeal swallowing efficiency(PSE) in patients with aspiration were significantly different from other groups. After neck position change, aspiration could be reduced in all of 7 patients, and laryngeal penetration reduced hy about 82%. PTT ancl PSE were also improved after position change. Aspiration and laryngeal penetration occurred more frequently in thin liquid swallowing than in thick liquid and solid swallowing. CONCLUSION: PTT and PSE were useful for the evaluation of dysphagia. Aspiration and laryngeal penetration could be reduced when appropriate position assumed, We could decrease the chance of aspiration by changing the patient diet consisIency. Scintigraphy might be useful tool to quantitate and follow up these changes.
Barium ; Colloids ; Deglutition ; Deglutition Disorders* ; Diet ; Evaluation Studies as Topic* ; Follow-Up Studies ; Humans ; Neck ; Ovum ; Radionuclide Imaging* ; Steam ; Tin ; Viscosity ; Water ; Yogurt

BACKGROUND: Chicken pox and herpes zoster are caused by the varicella-zoster virus(VZV). To investigate the epiderniologial relationship between clinical isolates of VZV, it is essential to distinguish different isolate. OBJECTIVE: This study was conducted to classify the VZV strains according to R5 tandem direct reiterations(TDR) copy numbers and Pst I endonuclease cleavage site mutation, and to analyze the distribution pattern of VZV strains isolated in Korea. METHODS: Strains of VZV were isolated from 61 patients with herpes zoster who had not been immunized with a live vaccine of VZV. Copy numbers of R5 TDR which was located in variable region IV were measured by PCR. The presence of a Pst I cleavage site in a middle portion of the long unique region of VZV genome was analyzed by PCR thereafter restriction enzyme digestion(PCR-RFLP). RESULTS: VZV strains isolated in Korea contained one to three copy numbers of R5 TDR. Of 61 isolates, 43(70%) comtained 2 copies of R5 TDR, while 11(18%) isolates contained only one copy and 7(12%) isolat s contained 3 copies. About 16% of the strains examined did not have a PstI cleavage site, although the majority of strains retained this site. VZV strains could be classified into 6 strains on the basis of the copy number of R5 TDR and PstI cleavage site, in which the strain with 2 copies of R5 TDR and PstI cleavage site positive was the most frequent type (36 out of 61 isolates) in Korea. Four batches of live attenuated vaccine(Biken) that is now used in Korea showed 2 copy numbers of R5 TDR and PstI site negative. CONCLUSION: The copy number of R5 TDR and the presence of PstI cleavage site seems to be a reliable marker for dicrimination of VZV strains in Korea. This discrimination can be used to study the molecular epiclemiology of VZV and as a criterion for identification of vaccine-related isolates.
Chickenpox* ; Discrimination (Psychology) ; Genome ; Herpes Zoster* ; Humans ; Korea* ; Polymerase Chain Reaction ; Repetitive Sequences, Nucleic Acid*

The fibrosis involved in gluteus maximus causing limitation of flexion and adduction of the hip has become a recognized clinical entity since the first report by Fernandez de Valderrma in 1969. Its most constant and characteristic histologic feature was substitution of the fibrous tissue in the definitive etiology was unknown but presumed to be multiple intramuscular injections. Authors present three cases of the fibrosis involving gluteus maximus. In two cases Z-lengthening was performed on the thickened fibrous bands with good results.
Fibrosis ; Hip ; Injections, Intramuscular

The oropharyngeal swallow of 26 patients with dysphagia was studied quantitatively and qualitatively using videofluoroscope. Videofluoroscopic examination was done with head in neutral position, and with three different c onsistency of test meals; thin liquid, thick liquid, and solid, When aspiration or laryngeal penetration was noted in neutral position, the study was repeated with different head positions, We compared them with each other and with 25 normal subject(previously presented). 11/26(42%) patients revealed laryngeal penetration or aspiration at least with one consistency of test meal. Aspiration occurred more frequently in thin liquid than thick liquid or solid, Head position change successfully eliminated aspiration in 10/10 patients(100%). Other one patient could not change his head position. 9 numerical parameters were derived and calculated for quantitative examination, Liquid meal oral discharge time, pharyngeal delay time, and pharyngeal transit time were significantly increased in patients with aspiration than in patients without aspiration. Also significantly increased than those of normal controls. Because different test meal consistency gave different values, direct comparison of values regardless of meal consistency was fruitless. And because all the process of swallowing cannot be expressed as numerical parameters qualitative examination of videofluoroscopic result was essential. In conclusion, liquid meal oral discharge time, pharyngeal delay time, and pharyngeal transit time were useful parameters in differentiating and quantifying dysphagia. Aspiration can be reduced when appropriate position assumed. Calculated values were different a according to the consistency of the test meal. Quantitative analysis was helpful, but qualitative examination of videofluoroscopy was essential.
Deglutition Disorders* ; Deglutition* ; Head ; Humans ; Meals ; Posture* ; Viscosity*

Hereditary anhidrotic ectodermal dysplasia is a rare condition characterized by underdeveloped ectodermal structure including the skin, teeth or skin appendages. The patient has characteristic feature of anhidrosis, hypotrichosis and defective dentition. We experienced a case of hereditary anhidrotic ectodermal dysplasia in a l-month-old male infant who had unexplained recurring fever, anhidrosis and characteristic facial feature, so we established the diagnosis with clinical feature and skin biopsy.
Biopsy ; Dentition ; Diagnosis ; Ectoderm ; Ectodermal Dysplasia* ; Fever ; Humans ; Hypohidrosis ; Hypotrichosis ; Infant ; Male ; Skin ; Tooth

The multistage maximal exercise test was performed to 135 cases with various heart disease and 207 control group between jan. 1980 and Dec. 1980 in KoreaGeneral Hospital. The change of heart rate, blood pressure and ST segment in various heart disease were compared with those in control group. The results were followings; 1. There were 130 male and 77 female of cases with control group, whose mean age were 50 years old. 2. General check up was the most common underlying disease of control group(67 patients) and the others were gastritis (28), neurosis (24), diabets mellitus (17), hepatitis (4) and peptic ulcer (4) frequency. 3. Change of heart rate, blood pressure and ST segment in control group during GXT were 89~154, 119/80~157/88 mmHg and 0.6~2 mm. 4. There were 81 male and 51 female of cases with various heart disease group, whose mean age were 50 years old. 5. Atherosclerotic heart disease was the most common underlying disease of various heart disease group (49 patients) and the others were hypertension (34), hypertensive cardiovascular disease (22), labile hypertension (14), angina (7), arrythmia (6) and others (3) in frequency. 6. Change of heart rate, blood pressure and ST segment in various heart disease group during GXT were 85~148, 140/93~178/102 mmHg and -0.7~1.3mm. ST segment in atherosclerotic heart disease, hypertension, hypertensive cardiovascular disease, valvular heart disease and myocardial infarction were significantly depressed(p<0.05) compared with ST segment in control group.
Arrhythmias, Cardiac ; Blood Pressure ; Cardiovascular Diseases ; Exercise Test* ; Female ; Gastritis ; Heart Diseases* ; Heart Rate ; Heart Valve Diseases ; Heart* ; Hepatitis ; Humans ; Hypertension ; Male ; Middle Aged ; Myocardial Infarction ; Peptic Ulcer

PURPOSE: To clarify the chracteristic sonographic features of benign soft tissue tumors and to evaluate the usefulness of sonographic imaging. MATERIALS AND METHODS: We retrospectively reviewed ultrasonographic images of 70 cases in 68 patients with histologically proved benign soft tissue tumors. RESULTS: The tumors included 33 lipomas, 11 hemangiomas. 11 lymphangiomas, 7 neurilemmomas, 4 epidermold cysts, 2 fibromas, 1 mesenchymoma, and 1 myxoma. The SOhographic appearances of the lesions were mainly solid in 53 cases(33 lipomas, 8 hemangiomas, 2 lymphangiomas, 7 neurilemmomas, 2 fibromas and 1 mesenchymoma), mainly cystic in 14 cases(1 hemangioma, 8 lymphangiomas, 4 epidermoid cysts, and 1 myxoma), and mixed in 3 cases(2 hemangiomas and 1 lymphangioma). Although an accurate histologic prediction could not be made in most cases, certain patterns appeared to be characteristic of specific tumor types. 26 cases(78%) of lipoma were seen as lentiform, iso- or hyperechoic, solid mass. Hemangioma had variable appearance and chacteristic calcifications were seen in 3 cases. Unicameral or multiseptated cystic mass with variable thickness of echogenic septa and solid portion was the characteristic finding of lymphangioma. Neurilemmoma showed Iobulated, oval to round, relatively hypoechoic mass with or without internal cystic portion. CONCLUSION: Sonographic evaluation of benign soft tissue tumros is useful in demonstrating the location, size, extent, and internal characteristics of the mass. A relatively confident diagnosis can be made when the characteristic features of the benign soft tissue tumor are present on sonographic imaging.
Diagnosis ; Epidermal Cyst ; Fibroma ; Hemangioma ; Humans ; Lipoma ; Lymphangioma ; Mesenchymoma ; Myxoma ; Neurilemmoma ; Retrospective Studies ; Ultrasonography

Vanadate is a trace element in animal tissues and has been known to inhibit NA(+)-K(+) ATPase in various tissues including skeletal and cardiac muscles and smooth muscles. Vanadate shows contractile actions on various types of smooth muscles. Prolonged dietary administration of vanadate has been shown to cause arterial hypertension, increased peripheral resistance, and a marked reduction of coronary, visceral and renal blood flow.In isolated vascular smooth muscle of aorta, application of vanadate caused contraction. These studies have been conducted the preparation of vascular smooth muscles from which endothelial cell were removed. It has been reported that endothelial cell releases relaxing factor(s) (endothelium-derived relaxing factor, EDRF) in response to acetylcholine and a number of other stimuli and also produces vasoconstrictor substances (endothelium-derived contracting factor, EDCF). The aim of this present experiment is to elucidate whether vascular response of isolated rabbit aorta induced by vanadate are endothelium dependent or not. The result obtained were summarized as follows ; 1) When endothelium was intact, vanadate induced vascular relaxation of aorta precontracted with norepinephrine. But K+ induced contraction was augmented by vanadate in the aorta with or without endothelium. Whereas relaxation produced by vanadate precontracted with angiotensin II was endothelium-independent. 2) Hemoglobin, methylene blue, hydroquinone, and verapamil inhibited vanadate-induced vascular relaxation. But indomethacin and quinacrine had no effect on vanadate induced vascular relaxation. From the above results, it is speculated the vanadate act on endothelium, modifies the synthesis or release of endothelium-dependent relaxing factor and thus changes the contractile responses to norepinephrine in rabbit aorta.
Acetylcholine ; Adenosine Triphosphatases ; Angiotensin II ; Animals ; Aorta ; Endothelial Cells ; Endothelium ; Endothelium-Dependent Relaxing Factors ; Hypertension ; Indomethacin ; Methylene Blue ; Muscle, Smooth ; Muscle, Smooth, Vascular* ; Myocardium ; Norepinephrine ; Quinacrine ; Relaxation ; Vanadates* ; Vascular Resistance ; Verapamil

No abstract available.
Leukemia*

We report the clinical features in one patients with episodic positional vertigo and apogeotropic direction changing horizontal positional nystagmus that does not fatigue, beating to the right with the head turned to the left and beating to the left with the head turned to the right. This syndrome probably represents a horizontal semicircular canal variant of benign positional vertigo. Free-floating debris and Cupula attached debris in one horizontal semicircular canal may explain many of the clinical and oculographic findings.
Fatigue ; Head ; Humans ; Nystagmus, Physiologic ; Semicircular Canals ; Vertigo*